十二指肠低张多排螺旋CT显示胰头-壶腹区病变

Lesion at ancreatic head- ampulla region reflected on hypotonic duodenography multidetector spiral

目的 了解十二指肠低张增强CT显示胰头-壶腹区的解剖结构及病变.方法 多排螺旋CT增强扫描前肌注654-2 5 nag、口服清水500ml,CT薄层MPVR重建显示胰头-壶腹区的解剖结构及病变.结果 十二指肠壁、胆总管壁,环绕胆总管的脂肪线的厚度均匀,分别为2.5、2.0、2.6mm.胆总管与十二指肠、胰腺间脂肪线的显示率为85%（11/13）、54%（7/13）,乳头的显示率77%（9/13）.12例胆总管内结石病变分别表现为钙化影,环状钙化影.管腔内无强化软组织影.1例只表现为胆管扩张.14例胰头-壶腹区肿瘤,表现局部肿块、胆总管受侵狭窄、管壁增厚,脂肪线消失,部分累及十二指肠垂直部及水平部.大于3 cm肿块,在影像上不易区分其来源.结论 十二指肠低张CT薄层MPVR重建避免了胰头-壶腹区器官重叠.有助于病变显示.

Objective To explore anatomic structm＇es and lesions of pancrebead-ampulla area in hypotonic duodenography CT. Methods Images of anatomic structures and lesions of pancrehead-ampulla area were obtained with the CT 3D reconstruction scanner-Multiplanar Volume Reformation （MPVR） adopted after the intramuscular injection of 654-2 5mg and 500ml water had been given. Results The thickness of duodenum wall, common bile duct and fatty tissue were 2.5, 2.0, 2.6 mm respectively. Display rate of fatty tissue between common bile duct and duodnom, pancreas were 85% （11/13cases）, 54% （7/13 cases） respectively, while display rate of papilla were 77% （9/13cases）. Common bile duct stone were reflected as calcification, ringlike calcification, low density and endoluminal nonsolid soft tissue. Local mass, narrow interior, increased thickeness of tube wall, diminishing fatty tissue, partial perpendicularis and horizontalis of duodenum were captured reflecting features of pancreatic head - ampulla region tumors. It＇ s most impossible to identify its original derivation for those masses larger than 3cm. Conclusion A better image of lesions is expected to obtain with CT MPVR thin slice reconstruction which avoids organs overlapping on the image.