影响壶腹周围病变CT诊断的相关护理因素分析

目的：分析护理相关因素对壶腹周围病变CT诊断的影响。材料与方法：回顾性分析2010年1月至2011年12月间在我院行能谱CT增强检查并手术切除的壶腹周围病变共89例。分析因素包括受检区域支架或／和导管植入情况、十二指肠充盈清水情况、CT图像运动伪影情况、动脉期主动脉CT值、胰胆管扩张情况。以病理结果作为诊断金标准,分析CT定位诊断、定性诊断与上述因素之间的关系。结果：89例均静脉增强成功,两例出现运动伪影；68／89例十二指肠充盈。运动伪影和十二指肠充盈与诊断结果间没有显著性相关。23／89例有支架或／和导管植入,有无支架或／和导管植入与定性诊断准确与否存在相关性,与定位诊断之间没有显著性相关。胰头来源病变定位诊断准确率高于非胰头来源其它壶腹区病变,定性诊断准确率两者之间没有显著行差异；胰胆管扩张情况在两者间存在显著差异。结论：壶腹周围病变能谱CT增强检查成功率较高,受检区域支架或／和导管植入是影响局部病变定性诊断的主要因素之一,非胰头来源其它壶腹区病变定位诊断准确率低于胰头来源病变者。

Analysis of the influence of nursing related factors on the CT diagnosis of periampullary pathology

Purpose: To analyze the influence of nursing related factors on the CT diagnosis of periampullary pathology. Materials and Methods: 89 cases of periampullary lesions (Jan 2010 to Dec 2011) were included and studied retrospectively. All patients were scanned on spectral CT (Discovery CT750 HD, GE HealthCare, Milwaukee, USA) with contrast enhanced dual-phase protocol and underwent surgery after CT examination. The implantation of stent or/and catheter, the filling of water in the duodenum, the moving artifact on CT image, the CT value in the aorta, and the dilatation of pancreatic duct and bile duct were analyzed and recorded for each case. According to the pathological diagnosis, the subjects were divided into two groups with correct diagnosed and un-correct diagnosed for the lesion location and for the nature of the lesion respectively. The relationship between the nursing related factors and CT diagnosis were analyzed by Chi-square test with SPSS13.0. Results: The contrast medium injection was successful in all 89 cases, and moving artifact was observed in two cases. Water filling in the duodenum was observed in 68/89 cases. No differences were observed between two groups for the moving artifact and water filling in the duodenum. 23/89 cases had stent or/and catheter implantation, and there was difference between two groups concerning the CT diagnosis of nature of the lesion for the implantation of stent or/and catheter. The accuracy for location was higher in pancreatic head lesion than that in non-pancreatic periampullary lesions, while no difference was observed for the diagnosis of nature of the lesion in the two categories. Conclusions: The implantation of stent or/and catheter was one of the nursing related factors that maybe influence the CT diagnosis for the nature of periampullary pathology. The accuracy for location was lower in non-pancreatic periampullary lesion than that in pancreatic head lesion.