螺旋CT血管造影评价胰腺癌可切除性的意义

Spiral CT angiography in accessing the resectability of pancreatic cancer

目的探讨螺旋CT血管造影（SCTA）诊断胰腺癌胰周血管侵犯及评价可切除性的价值。方法10例疑有局部浸润的胰腺癌患者术前行横断面CT及螺旋CT血管造影检查。比较分析SCTA与横断面CT诊断肿瘤侵犯胰周血管情况以及评价肿瘤可切除性。结果SCTA诊断胰周血管侵犯的敏感度、阴性预测值（100％、100％）高于横断面CT（81．8％、92．6％）。两者差异有统计学意义（P〈0．05）。SCTA术前评价胰腺癌可切除性的阳性预测值高于横断面CT。结论SCTA可精确地诊断胰腺癌侵犯胰周血管的情况，术前可准确评价胰腺癌可切除性。

Objective The purpose of this study was to test the role of Spiral CT Angiography（SCTA） to predict vascular involvement from pancreatic cancer and the resectability of pancreatic tumors. Methods SCTA and axial CT scans were done to 10 patients who had adenoearcinoma of the pancreas. Of these patients 9 underwent radical surgery, vessel integrity of the superior mesenteric, superior mesenteric vein, and portal vein and cavum artery was assessed prospectively on both axial CT scans and SCTA. Results Spiral CT angiograms were obtained in all patients. Compared with axial CT images, SCTA was more accurate at revealing vessel encasement. The sensitivity and the negative predictive value of vessel encasement was both 100% for SCTA compared with 81.8% and 92. 6% for axial CT images（ P 〈 0. 05 ）. The positive predictive value of a resectable tumor was 100% for SCTA compared with 83. 3%for axial helical CT images. Conclusions Spiral CT angiography of the pancreas provides useful information about local vascular involvement from pancreatic carcinoma. Compared with conventional axial CT scans, SCTA improves surgeons＇ ability to predict the resectability of pancreatic tumors.