CT对胰腺癌诊断和临床评估价值

CT diagnosis and clinical evaluation of pancreatic cancer

目的探讨螺旋CT对胰腺癌诊断和临床评估价值。方法回顾性分析2015年11月至2019年10月行CT检查并经手术、穿刺活检病理证实为胰腺癌,并获随访的22例患者CT表现,对其肿块、胰周血管、神经、胰周脂肪间隙、邻近器官、转移的特点进行分析。结果胰腺癌位于胰头部13例,胰颈部2例,胰体部4例,胰体尾部2,胰尾部1例。胰管扩张12例,胆总管及肝内胆管扩张6例,腹腔动脉侵犯2例,肝总动脉侵犯1例,肠系膜上动脉侵犯3例,肠系膜上静脉侵犯1例,门静脉侵犯3例,脾静脉侵犯1例,胰周脂肪间隙侵犯6例,十二指肠侵犯4例,肝转移6例,胰周淋巴结转移3例,肝门部淋巴结转移1例,腹膜后淋巴结转移4例,腹腔肠系膜转移5例,大网膜转移2例,腹腔积液4例。结论螺旋CT能正确诊断胰腺癌及胰周组织侵犯,是判断胰腺癌能否手术的重要手段。

Objective To investigate the value of spiral CT in the diagnosis and clinical evaluation of pancreatic cancer.Methods Twenty-two patients with pancreatic cancer confirmed by operation and pathology from November 2015 to October 2019 were selected and retrospectively studied on CT features of tumor,peripancreatic vessels,nerves,peripancreatic fat space,adjacent organs and metastasis.Results Pancreatic masses were located at the head of pancreas in 13 cases,at the neck of pancreas in 2 cases,at the body of pancreas in 4 cases,at the body and tail of pancreas in 2 cases and at the tail of pancreas in 1 case.There were 12 cases with dilatation of pancreatic duct,6 cases with dilatation of common bile duct and intrahepatic bile duct,2 cases with celiac artery invasion,1 case with common hepatic artery invasion,3 cases with superior mesenteric artery invasion,1 case with superior mesenteric vein invasion,3 cases with portal vein invasion,1 case with splenic vein invasion,6 cases with peripancreatic fat space invasion and 4 cases with duodenal invasion.There were 6 cases with hepatic metastasis,3 cases with peripancreatic lymph node metastasis,1 case with hepatic hilar lymph node metastasis,4 cases with retroperitoneal lymph node metastasis,5 cases with peritoneal mesenteric metastasis,2 cases with omental metastasis and 4 cases with abdominal dropsy.Conclusion Spiral CT plays an important role in the diagnosis of pancreatic cancer and peripancreatic tissue invasion and in judging whether the patients can be operated for pancreatic cancer.