螺旋CT双期增强扫描诊断胰腺癌的价值

Evaluation of Two-phase Enhanced Helical CT for Pancreatic Adenocarcinoma

目的：探讨螺旋 ＣＴ双期增强扫描诊断胰腺癌的价值。材料和方法：２７例胰腺癌患者行螺旋 ＣＴ双期增强扫描，动脉期（ＡＰ）延迟２５ｓ，门静脉期（ＰＶＰ）延迟６５ｓ，以３～４ｍｌ／ｓ团注造影剂８０～１００ｍｌ。测量肿瘤和正常胰腺组织的ＣＴ值，计算肿瘤－胰腺密度差，对胰周血管观察评价。结果；肿瘤的平均ＣＴ值ＡＰ和ＰＶＰ是５１±８Ｈｕ、７４±１０Ｈｕ，正常胰腺的 ＣＴ值 ＡＰ和 ＰＶＰ是 １２３±１９Ｈｕ、１００±１０Ｈｕ，肿瘤－胰腺密度差 ＡＰ和 ＰＶＰ是 ７１±２０Ｈｕ、２５±１２Ｈｕ，二者差异明显（Ｐ＜０．０１）。胰周动脉侵犯在ＡＰ显示好，静脉侵犯在ＰＶＰ显示好。结论：ＡＰ可获得最大的肿瘤－胰腺密度差，ＡＰ结合ＰＶＰ对胰周血管侵犯的评价更全面准确。

Purpose: To evaluate the diagnostic value of two-phase enhanced helical CT in pancreatic adenocarcinoma. Materials and methods: Two-phase enhanced helical CT was performed in 27 patients during hepatic arterial phase (AP, 25s after infusion) and portal venous phase (PVP, 65s after infusion) with a 80 ~ 100ml bolus injection of contrast material at 3 ~ 4ml/s. CT attenuation values of tumor and normal pancreas as well as all major peripancreatic vessels were obtained and the tumor-pancreas contrast was calculated. Results: Mean tumor enhancement were 51±8Hu on AP and 74 ± 10Hu on PVP, normal pancreas enhancement was 123 ± 19Hu on AP and 100 ± 10Hu on PVP. Mean tumor-pancreas contrast was significantly greater on AP scans (71 ± 20Hu) than on PVP scans (25 ± 12Hu) (P< 0. 01). Invasinos of peripancreatic arteries were identified on AP scans, and invasions of veins with PVP scans. Conclusion: Excellent tumor-pan creas contrast is obtained with AP scans. Vascular invasions are detected clearly with AP&PVP scans.