螺旋CT增强扫描对小胰腺癌的诊断价值及临床意义

Enhanced spiral CT scan the diagnostic value of small pancreatic cancer and clinical significance

目的:探讨螺旋CT增强扫描对小胰腺癌的检查方法和诊断价值及其临床意义。方法:对本科76例行多期螺旋CT扫描的小胰腺癌进行回顾性分析,比较正常胰腺组织和肿瘤在平扫和三期的增强变化。根据CT征象分析病灶检出率行术前评估,并与手术结果比较。结果:在三期增强扫描中,正常胰腺组织胰腺期的增强值明显高于其它两期,胰腺一病灶增强差值胰腺期高于其它两期,小胰腺癌在胰腺期(35～45 s)显示最清晰。胰周血管在动脉期和静脉期显示满意。76例中,动脉期检出率为69.7%(53/76),胰腺期检出率为94.7%(72/76),门静脉期检出率为53.9%(41/76)。76例中,62例术前评估可切除的肿,有51例可切除,符合率为82.2%(51/62)瘤,但术中仍有11例不可切除;14例术前评估不可切除,符合率为100%(14/14)。结论:螺旋CT增强扫描在小胰腺癌检查中,胰腺期是小胰腺癌检出最佳期相,有极大的诊断价值;动脉期和门静脉期是病灶术前评估最好时期,它具有重要临床意义。

Objective：To investigate the enhanced spiral CT scan of small pancreatic cancer screening method and diagnostic value, and to assess the reseetability of clinical and unresectable. Methods： 76 routine spiral CT scan more of the small pancreatic cancer were retrospectively analyzed and compared in normal pancreatic tissue and tumor plain and enhanced three changes. According to lesion detection rate of CT signs in preoperative evaluation of parallel and compared with the surgical results. Results： In the third phase enhanced scan, the normal pancreas, pancreatic tissue was significantly higher than those of other enhancements to two, the pancreas of a pancreatic lesion increased the difference than other two, small pancreatic cancer in the pancreas of the （35 -45s） showed The most clear. Peripancreatic vessels in the arterial and venous phase shows satisfaction. 76 patients in the arterial phase detection rate 69.7% （53/76） ,pancreas on ttle detection rate was 94.7% （72/76）, portal venous phase detection rate was 53.9% （41/76）. 76 patients in the preoperative evalu＇,ation of 62 patients with resectable tumors, surgery is still not removed in 11 cases, 51 patients with resectable,the rate was 82.2% （51/62）. Preoperative evaluation of 14 cases of unreseetable,was 100% （ 14/ 14）. Conclusion： Spiral CT scan in the inspection of small pancreatic cancer,pancreatic best detection of small pancreatic phase, a significant diagnostic value ; arterial and portal venous phase is the best period of preoperative evaluation of lesions, it has important clinical significance.