螺旋CT双期增强对胰腺癌病人的术前评估

Dual phase spiral CT of pancreatic adenocarcinoma:assessment of resectability before surgery

目的探讨螺旋CT双期增强对胰腺癌可切除性术前评估的价值。方法对1999年5月～2003年3月期间行螺旋CT双期增强扫的45例诊断为胰腺癌病人的CT图像与22例手术结果进行对比研究,通过显示胰腺癌的部位、大小以及肿块对周围血管侵犯程度、远处器官转移以及后腹膜淋巴结转移,作出能否切除的术前评价。结果45例胰腺癌病人中18例位于胰头,16例位于胰体尾,11例位于胰尾;27例患者接受手术治疗,其中22例术前SCT认为肿瘤可切除,实际成功切除17例,成功切除的阳性预测值达77%,其他5例SCT认为肿瘤不能切除,实际手术均不能切除。结论螺旋CT双期增强扫描可作为一种评价胰腺癌术前能否手术切除的有效方法。

Objective To study the accuracy of dual-phase spiral CT in the preoperative assessment of resectability in patients with pancreatic adenocarcinoma.Methods Between May 1999 and March 2003,45 patients with pancreatic adenocarcinoma underwent preoperative evaluation and staging with dual phase spiral CT,compared with 22 patients with pancreatic adenocarcinoma among them by surgery,in terns of the lesions locations,sizes,degrees of tumor-arterial/venous invasion,metastases and lymph metastases.Results The locations of fourty-five patients were the head of pancreas(18 cases),the body and tail of pancreas(16),and the tail of pancreas(11 cases),22 of 27 cases were predicted to be resectability by CT.whereas 17 cases werc successful resection so that the accuracy of the positive predictive value for resectability was 77 %.5 cases were predicted to be unresectable by CT and were demonstrated by the surgery.Conclusion Dual-phase spiral CT is useful technique for preoperative staging and resectable assessment of pancreatic adenocarcinoma.