多层螺旋CT胰周血管成像对胰腺癌可切除性评估的应用

Application of multislice CT peripancreatic vascular imaging for assessment of pancreatic cancer excision

目的：探讨多层螺旋CT胰周血管成像对胰腺癌可切除性评估的应用情况。方法分析重庆市合川区人民医院2010年2月～2014年3月收治的60例胰腺癌患者临床资料，均采用螺旋CT扫描与手术对照。观察胰腺血管侵犯Loyer分型、胰腺周围主要动脉和静脉受侵犯分级情况。结果螺旋CT评估胰腺血管侵犯Loyer分型可切除血管206支，不可切除血管74支；螺旋CT评估胰腺周围主要动脉受侵犯分级可切除动脉157支，不可切除11支；螺旋CT评估胰腺周围主要静脉受侵犯分级可切除静脉69支，不可切除43支；螺旋CT评估Loyer分型可切除准确率为71.0%（199/280），血管受侵犯分级可切除准确率为77.8%（218/280）。结论多层螺旋CT在胰腺癌血管侵犯的可切除性评估中起着重要的补充作用，在胰腺癌血管侵犯多层螺旋CT评估中对动、静脉评判标准要有所区别，才能提高评估的准确性。

Objective To discuss the application of multislice CT peripancreatic vascular imaging for assessment of pancreatic cancer excision. Methods The clinical data of 60 cases of patients with pancreatic cancer in People＆#39;s Hos-pital of Hechuan District in Chongqing City from February 2010 to March 2014 were analyzed. All patients were given multislice CT scan and confirmed by surgery. The vascular invasion Loyer classification, degree of arterial invasion and intravenous invasion around the pancreas were observed. Results Multislice CT assessed pancreatic vascular invasion Loyer classification of excision blood vessels were 206 branches, non-excision blood vessels were 74 branches. Multi-slice CT assessed degree of arterial invasion around the pancreas of excision blood vessels were 157 branches, non-ex-cision blood vessels were 11 branches. Multislice CT assessed degree of intravenous invasion around the pancreas of excision blood vessels were 69 branches, non-excision blood vessels were 43 branches. The excision accuracy of Loyer classification assessed by multislice CT was 71.0% （199/280）, which of vascular invasion degree around the pancreas was 77.8% （218/280）. Conclusion Multislice CT plays an important complementary role in assessment of pancreatic cancer vascular invasion excision. Multislice CT assessment of pancreatic cancer vascular invasion should distinguish arterial and intravenous judgment criteria, which can improve the accuracy of the assessment.