胰腺动脉螺旋CT解剖的研究--正常表现及临床意义

目的研究正常胰腺供血动脉的CT表现及变异,探讨显示胰腺供血动脉的最佳扫描方法.方法对50例非胰腺病变行上腹部增强CT扫描的病人,采用薄层动态、大剂量团注对比剂扫描,观察胰腺直接供血动脉与间接供血动脉(腹腔干、肝总动脉、脾动脉、胃十二指肠动脉和肠系膜上动脉)的CT表现,统计显示率. 结果胰腺间接供血动脉全部显示,直接供血动脉显示例数分别为胰十二指肠上前动脉48例(96%),胰十二指肠上后动脉30例(60%),胰十二指肠下前动脉31例(62%),胰十二指肠下后动脉18例(36%),胰背动脉20例(40%),胰大动脉13例(26%),胰横动脉6例(12%),胰尾动脉8例(16%).结论采用螺旋CT薄层扫描与重建技术、大剂量快速团注对比剂及合理的扫描延迟时间可得到胰腺供血动脉的良好显示.

Study of Pancreatic Arterial Anatomy with Sprial CT Scanning:Normal Appearences and Clinical Implications

Objective To investigate the normal CT appearances and frequency of visualization of pancreatic arteries during the arterial phase of spiral computed tomography, and to discuss the optimal scanning method for displaying the anatomy of pancreatic arteries. Methods Arterial phase spiral CT (3 mm collimation, 1 mm reconstruction interval) was performed in 50 patients with normal glands during power injection of 2 ml/kg of Ultravist at 3 ml/s. Three radiologists observed and recorded the frequency of visualization of the indirect pancreatic supplying arteries (including celiac, hepatic, splenic, gastroduodenal, superior mesenteric arteries) and direct supplying arteries (anterior- and posterior-superior pancreaticoduodenal, anterior- and posterior-inferior pancreaticoduodenal, dorsal pancreatic, pancreatic magna, transverse pancreatic, and caudal pancreatic arteries). Results The indirect supplying arteries were seen in all patients. The CT visualization rates of anterior- and posterior-superior pancreaticoduodenal arteries were 96% and 60% respectively, anterior- and posterior-inferior pancreaticoduodenal arteries were 62% and 36% respectively, dorsal pancreatic, pancreatica magna, transverse pancreatic, and caudal pancreatic arteries were 40%, 26%, 12% and 16% respectively. Conclusion Pancreatic arteries can be delineated on thin-slice spiral CT scans by using high dose and faster rate of injection of contrast during optimal scanning delay in arterial phase.