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1、多層螺旋CT掃描技術在胰腺癌診斷中的應用價值【摘要】目的研究螺旋CT多期掃描技術在胰腺癌診斷中的臨床應用價值。方法88例胰腺癌患者行螺旋CT多期掃描，掃描時間為注射造影劑后18～25s、40～45s和60s左右，比較正常胰腺組織和腫瘤在平掃和動脈期、胰腺期、門靜脈期的增強變化。依照CT征象診斷胰腺癌并行術前評估，并與手術結果比較。結果正常胰腺組織在胰腺期的增強值明顯高于其他兩期(F=12.22,P<0.01);胰腺-病灶增強差值胰腺期高于其他兩期(F=14.91,P<0.01)，腫塊在胰腺期能夠
2、清晰顯示。胰周血管在胰腺期顯示滿意，諸動脈在動脈期、胰腺期與門靜脈期相比，差異有顯著性(P<0.01);諸靜脈在胰腺期、門靜脈期與動脈期相比差異有顯著性(P<0.01)。55例不可切除的腫瘤中，血管受侵者32例(58.18%),其中胰周小靜脈擴張者19例(34.54%)。40例術前認為可切除的腫瘤，術中仍有7例不可切除。結論多層螺旋CT雙期掃描診斷胰腺癌，胰腺期和門靜脈期應作為首選方案，具有非常重要的臨床意義。【關鍵詞】胰腺癌;X線計算機;體層攝影術;術前評估 Abstract：Objecti
3、veToinvestigatetheclinicalvalueofmultislicespiralCT(MSCT)scanninginthediagnosisofpancreaticadenocarcinoma.Methods88patientswithpancreatic10adenocarcinomaunderwenttriple-phasespiralCTscanning18-25seconds,40-45secondsand60secondsaftertheinjectionofcontrastme
4、diumforangiography.Normalpancreatictissuesandthetumorwerecomparedbynormalscanningandtriple-phasespiralCTscanningsoastoexplorethevariationsinenhancedscanning.ThediagnosisofpancreatictumorwasbasedontheMSCTfindings,whichwereassessedpreoperativelyandlatercompa
5、redwiththesurgicalresults.ResultsDensitydifferenceofnormalpancreaswasgreatestonimagesobtainedinthepancreaticphase(F=12.22,P<0.01);meantumor-glandattenuationdifferencewasthegreatestonthoseobtainedinthepancreaticphase(F=14.91,P<0.01).Tumorandperipancre
6、aticvasculaturewerewellvisualizedinthepancreaticphase.Forvesselsdetection,sensitivityofarteriesobtainedinthearterialandpancreaticphaseswassuperiortothatofthoseobtainedinportalveinphase(P<0.01);sensitivityofveinsobtainedinpancreaticandhepaticphaseswasbet
7、terthanthatofthoseobtainedinarterialphase(P<0.01).Vascularinvasionof32casesweredetectedamong55unresectablecases(58.18%),ofwhich19caseswithexpansionofsmallveinsweredetected(34.54%).Of40caseswhichhadbeenpreoperativelydiagnosedasresectable,7caseswerenotres
8、ectableduringoperation.ConclusionInthe10diagnosisofpancreaticadenocarcinomabydual-phasespiralCT,pancreaticandportalveinphasesshouldbeselectedasthefirstscheme,whichhasveryimportantvalueinclinicalapplication.
