多层螺旋CT三期扫描在功能性胰岛细胞性肿瘤诊断中的价值

The value of the three-phase scan of multi-slice CT for diagnosis the functional Islet Cell Tumor

目的探讨多层螺旋CT三期扫描在功能性胰岛细胞瘤诊断中的应用价值。方法回顾性分析手术病理证实的13例功能性胰岛细胞瘤,PHIllips16排螺旋CT三期扫描,薄层重建;造影剂300或370mI/l,剂量1—1.5ml/Kg体重,注射速度4ml/s,动脉期、静脉期及平衡期分别延迟25秒,45秒及3分钟。结果胰岛细胞瘤三期扫描可见三种强化模式:(1)动脉期环形强化,静脉期向心性强化,平衡期整个病灶完全强化;(2)动脉期明显均匀强化,静脉期或平衡期呈等密度;(3)动脉期明显强化,静脉期、平衡期增强稍消退。其中恶性肿瘤征象包括肿块无包膜、动脉期环形强化、延迟期不均匀强化,局部淋巴结肿大等征象。结论多层螺旋CT三期扫描在提高功能性胰岛细胞肿瘤病灶的检出率、鉴别良、恶性方面均有其优势。

Objective To investigate the value of the three-phase scan of multi-slice CT for diagnosis the function islet cell tumor. Methods 13 functional islet cell tumor has been analysis retrospectively by surgery and pathology confirmed and checked by Phollips 16-slice CT scan. The scan parameter included three-phase scan, reconstruction：3mm thicken; contrast agent 300 or 370 mI / l, dose 1-1.5 ml / Kg weight, injecting speed 4 ml / s. Arterial, intravenous and balance phase were delayed 25 seconds, 45 seconds and three minutes, respective. Results Three are enhanced scanning mode in ICT： （1） ring enhancement of artery phase and centrality enhancement of vein phase, the entire lesion completely enhanced of balance phase;（2）homogeneous enhancement significantly of arterial phase and isodensity of venous or balanced phase; （3）enhancement significantly of the arterial phase, and washout mildly of venous and balanced phase. Signs of malig- nant tumors included non-coated, ring enhancement of arterial phase, unhomogeneous enhancement of the delay phase,local lymph nodes and other symptoms. Conclusion It can improve the ICT detection rate for three phase scan of multi-slice CT scan. The identification of benign and malignant ICT has its advantages.