胰腺癌螺旋CT双期增强的表现

Duai-phase spiral CT features of pancreatic carcinoma

目的 了解螺旋CT胰腺期、门脉期双期增强扫描显示胰腺癌的CT表现。方法 对 39例胰腺癌患者行双期增强扫描 ,扫描延迟时间分别为 35秒和 6 5秒 ,对比剂用量 10 0ml,注射速度 3ml s,观察胰腺癌在双期的增强情况和CT征象。结果 (1)直接征象 :胰腺癌表现为病变区胰腺肿大 ,形成肿块 ;平扫肿块密度通常呈略低密度、等密度 ;胰腺期增强扫描 :肿瘤主要表现为均匀或不均匀的低密度病灶 ,边缘呈规则或不规则的环状强化 ;门脉期 :肿瘤和正常胰腺组织间密度差下降。 (2 )间接征象 :伴有肝内胆管 (48.7% )、胆总管 (6 1.5 % )和胰管 (38.5 % )不同程度的扩张和胆囊增大 (30 .8% ) ,胰周脂肪消失 (82 .1% ) ,胰周大血管模糊 (5 1.2 % ) ,胰体、胰尾萎缩 (2 5 .6 % )以及转移性改变。结论 螺旋CT双期扫描能清晰地显示胰腺癌 ,有利于胰腺癌的早期诊断。

Objective To investigate dual-phase helical CT features of pancreatic carcinom in pancreatic phase and portal phase.Methods Dual-phase helical CT was performed on 39 patients with pancreatic cancer with 100ml intravenous contrast material injected at a rate of 3ml/s. Pancreatic phase (pp) and portal venous phase (pvp) began at 35 seconds and 65 seconds after the start of the injection respectively. The enhancement of pancreatic cancer and CT findings were observed.Results (1)Direct sings: The pancreatic cancer appeared enlargement of pancreas and took soft tissue mass in region of pathological changes, the density of soft tissue mass showed low-density or parity density in plain scan. The tumor conducted uniform or uniform low-density lesions and the margin showed regular or irregular annular enhancement in helical CT of pancreatic phase. The density difference of tumor with normal pancreas was descent in portal phase. (2)Indirectly sings: It accompanied with enlarge of distinct degree of cholangio of inner place liver(48.7%), choledochus (61.5%) and pancreatic ducts (38.5%) and broadening of cholecystis (30.8%), the fat of peripheral pancreas was disappeared (81.2%), the great blood vessels of peripheral pancreas was ill define (51.2%) , the pancreatic body and tail were atrophy (25.6%) and showed metastatic focus.Conclusion Dual-phase helical CT could delinease pancreatic cancer and afford more information for the early diagnosis.