B超与CT检查在壶腹癌诊断中的临床价值

The clinical value of B-ultrasound and CT in diagnosis of ampulla carcinoma

目的 :探讨B超与CT检查在壶腹癌诊断中的应用价值。方法 :对 5 9例经手术病理证实的壶腹癌进行回顾性分析 ,其中 4 1例行Whipple手术 ,18例行姑息术作内或外引流。结果 :B超与CT扫描均示壶腹部软组织肿块为壶腹癌的直接征象 ,部分壶腹癌不能明确显示肿块 ,但胆总管远端与胰管近端间距缩小 ;十二指肠腔内充盈缺损及局部肠粘膜破坏 ,壶腹段胆总管壁不规则增厚和肝内、外胆管中高度扩张、胆囊增大、双管征是壶腹癌的间接征象 ,本组CT诊断正确率为 84 .7% ,而B超为 81.3%。结论 :B超检查仍是目前诊断壶腹癌初步筛选和行之有效的首选方法 ,CT检查对壶腹癌的定位、定性和胰管的显示有其优势 。

Objective:To evaluate the clinical value of B ultrasound and CT in detecting ampulla carcinoma. Methods:Fifty nine patients with ampulla carcinoma confirmed by operation and pathology were retrospectively analyed,forty one patients underwent operation named Whipple,eighteen patients underwent appeasemental therapy through intradraining or extradrainig.Results:Ampulla parenchymal tumor was direct exhibition of ampulla carcinoma,some cases had no definite tumor,but the space betwcen distal biliary tract and proximal pancreatic tube became shorter,filling defect in duodenum,destruction of local mucosa,the biliary tract inner wall which close to ampulla became not even thicken,excentric parenchymal tumor,hepatic moderate or severe chloangiectasis,gallbladder became bigger and two tube sign were indirect exhibition of ampulla carcinoma.Conclusion:Up to now B ultrasound is still a preferred and effective method for preliminary filtration and diagnosis of ampulla carcinoma.CT had its superiority for the qualitative/positional diagnosis of ampulla carcinoma and exhibiting pancreatic duct.The cooperation of B ultrasound and CT can elevate the accuracy of diagnosis of ampulla carcinoma.