影像学检查在壶腹周围癌诊断中的应用价值

Evaluation of Imaging Examinations in the Diagnosis of Periampullary Carcinoma

目的 探讨各种影像学检查在壶腹周围癌诊断中的应用价值。方法 对我院 1991年 1月至 2 0 0 0年 12月 10年间收治的 12 5例经病理组织学检查证实的壶腹周围癌患者的临床影像学检查资料进行回顾性分析。结果 胰头癌中BUS或CT的诊断阳性发现率高于ERCP(P =0 .0 44 ,P =0 .0 2 9) ;十二指肠乳头癌中ERCP的诊断阳性发现率高于BUS和CT(P =0 .0 0 5 ,P =0 .0 3 ) ;壶腹癌中ERCP的诊断阳性发现率高于BUS和CT(P =0 .15 7,P =0 .2 82 )。磁共振胰胆管成像 (MRCP)在壶腹癌和十二指肠乳头癌的诊断中阳性发现者分别为 8/8和 8/9。结论 BUS +CT检查是诊断胰头癌的最佳方法 ;ERCP是诊断壶腹癌和十二指肠乳头癌的最佳方法 ;

Objective To evaluate the imaging exa mination in the diagnosis of periampullary carcinoma. Methods A retrospective analysis of 125 patient s with pathologically proven periampullary carcinomas enrolled in Zhongshan hosp ital between Jan. 1991 and Dec. 2000. Results The accuracy of BUS or CT was higher th an that of ERCP in patients with pancreatic head carcinoma ( P =0.044, P =0. 029, respectively). The accuracy of ERCP was higher than that of BUS or CT in pa tients with duodenal papillary carcinoma ( P =0.005, P =0.03, respectively). The accuracy of ERCP was higher than that of BUS or CT in patients with ampulla ry carcinoma ( P =0.157, P =0.282, respectively). The accurary of MRCP was 8 /8,8/9 respectively in patients with duodenal papillary carcinoma and ampullary carcinoma. Conclusion BUS+CT is the manner of choice in th e diagnosis of pancreatic head carcinoma, ERCP is suitable for nonpancreatic per iampullary cancer. MRCP should be applied widely in the near future.