正常胰腺与胰癌的CT研究——着重胰周结构

CT STUDY OF NORMAL PANCREAS AND PANCREATIC CANCER WITH EMPHASIS ON PERIPANCREATIC STRUCTURES

收集100例正常胰腺、51例胰癌的CT及临床资料,测得正常胰腺厚度:胰头16.79～40.15mm,胰体10.05～29.10mm,胰尾9.01～26.07mm。胰头结节状变异的特征是与胰的密度、结构一致,胰周各部脂层变异较大,判定胰腺是否正常时胰头测量价值有限,胆管扩张有助于小胰癌的发现。胰癌不可切除的CT指征有:肠系膜上动脉、下腔静脉、腹主动脉、胃、肝、脾及较大范围的肠系膜上静脉受浸润,胰头癌距肝门距离少于4环,肝转移。以此为基础的CT分期有助于胰癌手术可切除性及患者存期的判断。

One hundred normal pancreases and 51 pancreatic cancers were studied by using CT scanning. The normal dorso-ventral thickness of the head was 16.79-40.15mm, the body 10.05-29.10 mm and the tail 9.01-26.07mm. The luber viration of the head was consistant with the other parts of the organ in density and structure. The peripancreatic fat layers varied extens-ively except those separating the pancreas from the abdominal aorta and the superior meseateric arters. The dimentions of the head had little diagnostic value for pancreatic pathy, but a dilatation of the common bile duct was helpful in detecting small pancreatic cancers. The CT signs of unresectable pancreatic cancers include : ( 1 ) invasion of the superior mesenteric artery, inferior vena cava, aorta, liver, stomach and spleen and extensive invasion of the superior mesenteric vein; (2) ring nember ' less than 4; (3) metastasis into the liver. A grading system based on the above study can be useful in assessing the resectability of pancreatic cancer and estimating the patient's sturvival span after surgery.