螺旋CT双期薄层增强扫描在胰岛素瘤诊断中的应用价值

Dual-phase Contrast Enhanced Spiral CT Scanning for Insulinoma

目的探讨螺旋CT双期薄层增强扫描在胰岛素瘤诊断中的价值。资料与方法经手术病理证实的胰岛素瘤患者16例,术前行胰腺螺旋CT双期薄层增强扫描。扫描延迟时间动脉期21～26s,门静脉期65～70s。注射非离子型对比剂80～100ml,注射流率2.5～3.0ml/s。采用单层螺旋CT扫描10例,16层螺旋CT扫描6例。扫描层厚2.5～3.0mm。结果16例中,检出12例动脉期均为高密度,门静脉期10例为等密度,2例为高密度,瘤体直径0.8～2.5cm;4例平扫及增强均未发现明显肿瘤。16例中肿瘤单发14例,多发2例。结论螺旋CT动脉期增强薄层扫描能更清晰地显示胰岛素瘤,结合门静脉期对提高胰岛素瘤的检出率和诊断符合率有较高的临床应用价值。

Objective The purpose of our study was to evaluate dual-phase contrast enhanced spiral CT in the diagnosis of insulinoma in clinical practice. Materials and Methods Biphasic contrast enhanced spiral CT was performed in 16 insulinomas patients proved surgically and pathologically. Of 16 cases, ten patients were performed by single-slice spiral CT and six by 16-slice spiral CT. 80 - 100ml nonionic contrast agent was injected at the rate of 2.5 - 3 ml/s. The scan delay time of the arterial phase and portal venous phase was 21 -26s and 65 -70s respectively. Results 12 of 16 insulinomas were detected. All of them were hyperdense in the arterial phase. Ten insulinomas were iso-dense and two were still hyperdense in portal venous phase. （0.8 -2.5 cm in size）. No lesion was detected on both plain and enhanced spiral CT scans in 4 cases （25%）. 14（87.5% ） cases were single and 2 （12.5%） cases were multiple. Conclusion For patients presented with Whipple＇ s triad symptoms, dual-phase contrast enhanced spiral CT can improve the diagnostic accuracy if delay-time was chosen properly.