胰腺癌与胰腺炎的胰胆管扩张的CT表现

CT Features of Pancreaticobiliary Duct Dilation in Pancreatic Carcinoma and Choronic Pancreatitis

目的:研究胰胆管扩张对胰腺癌与慢性胰腺炎的诊断意义。方法:回顾性分析49例胰腺癌和36例慢性胰腺炎的CT资料。结果:胰腺癌主要特征包括:①胰腺癌多来源于导管上皮,常堵塞胰管引起梗阻远段的扩张,并多在胰头肿块处截断(16例,占80%);②胆总管扩张,并突然截断(27例,占87%),并可见肝内外胆管扩张(19例,占38.8%);③双管征(19例,占38.8%)。慢性胰腺炎组的主要特征为:①正常主胰管,在胰头部分的最大内径为3mm,向体尾部逐渐变细。慢性胰腺炎胰管扩张多呈不规则型串珠状并贯通病变区(7例,占77.8%),部分可见钙化或结石(5例,占13.9%)。②扩张的胆总管由上至下逐渐变细(7例,占100%)。结论:胰胆管CT表现的形态特征对胰腺癌与慢性胰腺癌的诊断有鉴别意义。

Objective： To study the diagnostic value of pancreaticobiliary duct dilation in pancreatic carcinoma and chronic pancreatitis. Methods： CT findings of pancreatic carcinoma in 49 Cases and chronic pancreatitis in 36 cases were retrospectively analyzed. Results： In 49 patients with pancreatic carcinoma the following features were observed ： （1） dilated pancreatic duct,with smooth and regular caliber （n = 16.80% ） ; （2） dilated common biliary duct,ruptured suddenly in most cases（n = 27, 87. 1% ）, with intra-and extra-hepatic cholangiectasis （n = 19,38.8% ） ; （3） double duct sign （n = 19,38.8% ）. In 36 patients with chronic pancreatitis the following signs were seen： （1） irregularly dilated pancreatic duct, running through the lesion （ n = 7,77.8 % ） with calcifications and calculus along the pancreatic duct （ n = 5,13.9% ） ; （2） dilated common biliary duct, tapering from above downward （n = 7,100% ）. Conclusion： CT characteristics of pancreaticobiliary duct dilation are very helpful in diagnosing pancreatic carcinoma and differentiating cancer with Chronic pancreatitis.