胰腺癌多层螺旋CT诊断

MSCT diagnosis of pancreatic adenocarcinoma

目的探讨胰腺癌早期cT表现特点。方法回顾性分析经病理证实的胰腺癌34例，其中男22例，女12例，年龄29岁-81岁，平均年龄63．7岁。34例均行CT平扫加增强检查，分别对病变的大小、形态、密度及强化方式进行分析。结果34例中肿瘤位于胰头部22例，胰体部8例，胰尾部4例。病变大小1．5cm-6．0cm，平均3．5cm。平扫表现为低密度29例，等密度5例；增强动脉期29例为低密度，5例为等密度；门脉期23例呈略高密度，8例呈低密度，3例呈等密度。胆总管、肝内胆管及胆囊扩张15例，胰管扩张23例，可见“双管征”8例，胰周脂肪层受侵25例，肝脏及腹膜后淋巴结转移17例。结论CT对早期小的胰腺癌的诊断有一定的难度，优化扫描技术是提高诊断水平的关键。

Objective To analyze the characteristics of CT diagnosis in early pancreatic adenocarcino- ma. Methods 34 pathologically confirmed cases of pancreatic cancer adenocareinoma（22 Male cases, 12 Female cases,63.7 years old on average）were all examined by CT diagnosis for the lesions＇ size, shape, density and strength separately. Meanwhile, assessment of the situations, such as the expansion of pancreatic duct and bile duct, pancreas atrophy, metastasis and so on were carried out. The outcome of patients with pancreatic head lesion in 22 cases,8 cases of pancreatic body,4 cases of pancreatic tail. Lesion size ranges 15 -60 mm,with an average of 35mm. 23 cases of lesions strengthen unevenly. The outcome of plain scan with 5 isogram cases and 29 low density cases;11 low density cases and 4 isogram cases on arterial phase ;8 low density cases and 7 isogram cases on portal phase. 15 cases indicated bile duct expansion, and 23 cases indicated expansion of pancreatic duct. 17 cases occured liver and peritoneal metastasis. Conclusion There is a certain degree of difficulty for CT scan diagnosis of small pancreatic adenocareinoma on early stage. Optimization of scanning technology is the key to raise the level of diagnosis.