多排螺旋CT在胰腺癌诊断及术前评估中的应用

Multi-slice CT:application in the diagnosis and preoperative evaluation of pancreatic cancer

目的探讨多排螺旋CT技术在胰腺癌诊断与术前评估中的应用。方法收集经胰腺多期增强扫描并病理证实的胰腺癌38例,分析其CT征象并运用VR、MIP、MPR、CPR技术行胰腺及胰周血管三维重建,判断胰腺癌周围浸润及血管侵犯情况,评估其手术可行性。结果多期扫描中动脉期肿瘤-胰腺密度差最大,为73±18 HU,肿瘤检出率达100%。38例胰腺癌中,10例显示胰周一支或多支血管受肿瘤侵犯包绕利用VR、MIP、MPR、CPR技术对病变及其周围血管进行三维重建并结合薄层横断图像,对肿瘤手术可切除判断准确率可达82.1%。结论多排螺旋CT多期、薄层扫描,能获得高质量的CTA、MPR、CPR图像,清晰显示病灶各种征象、与胰腺及胰周解剖结构的关系:有利于病灶定位、定性及局部侵犯的评价,对肿瘤可切除判断有重要指导意义。

Objective To evaluate the value of multi-slice CT in the diagnosis and pre-operation evaluation of pancreatic cancer. Methods 38 cases of pancreatic cancer proved pathologically underwent multi-phases CT scan. And CT features and the three-dimensional reconstruction imaging of pancreas and the vessels were analyzed by using VR, MIP, MPR and CPR technique. The infiltration of parenchyma and vessels around the pancreatic cancer and the feasibility of operation were estimated. Results The highest density difference between tumor and pancreas appeared in arterial phase and was 73±18 HU. One or more vessels around pancreas were infiltrated in 10 cases of pancreatic cancer. Combining with 3D reconstruction and thin slice axial imaging, the accurate resectable rate of the tumors was 82.1 %. Conclusion Thin-slice and multi-phases scan of multi-slice CT could obtain high quality of CTA, MPR and CPR images. The interrelation between the mass, pancreas and parapancreatic space, and all kinds of pathologic signs were displayed clearly. All of them were benefit to the determination of the location, qualitative act, local infiltration of the mass, and were also useful to the selection and practice of therapy.