螺旋CT双期增强扫描在小胰腺癌诊断中的应用

Dual-phase Helical CT in Diagnosis of Small Pancreatic Carcinoma

目的研究螺旋CT动脉期、门脉期双期增强扫描在小胰腺癌早期诊断和正确分期中的作用。方法对14例小胰腺癌患者行螺旋CT双期增强扫描,扫描延迟时间分别为30s和65s,对比剂量100mL,注射速度3mL/s,观察并比较正常胰腺及肿瘤在2期的增强情况。根据CT征象对肿瘤可切除性进行评价,并与手术结果比较。结果肿瘤-胰腺对比动脉期和门脉期分别为(48.07+20.4)HU和(28.80+16.04)HU(t=2.535,P≤0.01)。14例肿瘤中,术前认为可以切除11例,本中切除9例。结论螺旋CT双期增强扫描能更清晰地显示小胰腺癌,动脉期胰腺肿瘤对比较门脉期更显著,有利于小胰腺癌的早期诊断和可切除性的判断。

Objective To evaluate the use of dual-phase helicatl CT in arterial phase and portal venous phase of small pancreatic carcinoma.Methods Dual-phase helical CT wsa performed on 14 patients with small pancreatic carcinoma with 100 ml intravenous contrast material injected at a rate of 3mL/s,arterial phase and portal venous phase began at 30 seconds and 65 seconds after the start of the injection respectively.The enhancement of normal pancreas and tumor during the two phases was observed and compared.The assessment of tumor resectability based on CT findings was compared with surgical and histopathologic results.Results Tumorpancreas contrast was sig-nificantly greater in arterial phase（48.07＋20.4）HU than in portal venous phase（28.80＋06.04）HU（t = 2.535,P≤0.01）.11 of 14 tumors were thought resectable before operation,9 were actually resected in the opera-tion.Conchusion Dual-phase helical CT could delineate small pancreatic carcinoma clearly and afford more infor-mation for fhe diagnosis and the assessment of resectability of the lesion.The tumor-pancreas contrast was much bet ter in arterial phase than in portal venous phase.