壶腹癌的CT诊断

CT Diagnosis of Carcinoma of the Ampulla

目的:回顾分析壶腹癌的CT表现,提高其诊断正确性.材料和方法:收集经CT检查后手术病理证实壶腹癌15例.全部病例均经GE9800或Elscint2400高分辨CT机行增强扫描,层厚、层距为5.0mm.结果:15例壶腹癌CT表现为1)胰头钩突肿块7例;2)十二指肠腔内充盈缺损8例;3)15例胆总管显著扩张合并下端截断性阻塞,同时合并肝内胆管、胆囊扩张11例;4)胰管扩张9例.根据壶腹癌占据部位在CT上提出分型:l)胰头钩突肿块型;2)十二脂肠乳头型;3)混合型.结论:改进CT检查技术,对早期诊断及提高壶腹癌诊断正确率有益.

Purpose: This essay gave an analytic review of the correct diagnosis of carcinoma of theampulla on the basis of CT imaging. Materials and Methods: We found 15 patients withpathologically proven carcinoma of the ampulla. All the patients underwent CT examinationsusing high - resolution scanners (GE 9800 or Elscint 2400). The pancreas were scannedpost - contrast at contiguous sections with slice thickness and width of 5mm. Results: CTfindings of the 15 patients were classified as follow: 1) Tumor masses in the head of thepancreas were demonstrated in 7 cases;2)Filling defects in the duodenal lumen were found in8 cases;3)The dilation of common bile ducts as well as sudden termination in its lower por-tion were found in all 15 cases. In 11 patients, dilations of the gall bladders and the intra-hepatic bile ducts were noted;4)Dilations of pancreatic ducts were demonstrated in 9 cases.Ampullary carcinoma can be divided into three types according to the sites on CT images,i .e.1 )tumor mass in the pancreatic head, 2)mass in the vicinity of the duodenal papilla, 3)mixedtype. Couelusion: Improving the CT scanning systems and techniques are necessary for thebenefit of early and accurate detection of ampullary carcinoma.