64层螺旋CT检查对胰腺癌治疗的指导价值

目的:探讨胰腺癌的64层螺旋CT(容积CT/VCT)表现与临床的关系及对手术的指导价值。方法:回顾分析了35例经病理证实的胰腺癌,利用VCT的直接、间接征象以及临床表现,评估手术价值,分析检查技术的应用与病变检出率的关系。结果:35例中,动脉期检出33例(94%),门静脉期为28例(80%);胰头癌25例(71.4%),胰体癌8例(22.9%),胰尾癌2例(5.7%)。病灶直径在2.7~15 cm之间,直径小于3 cm的13例,其中囊腺癌4例。35例术前评估可手术切除18例,实际切除15例;17例不可切除。VCT评估可切除的准确率为83.3%,不可切除的准确率为100%。结论:VCT能较好地检出小于3 cm的小胰腺癌,尤其是CT血管成像可以直观显示肿瘤与周围结构的关系及血管受侵情况,在肿瘤分期及评估可切除与不可切除上具有较高价值。

The value of 64-slice spiral CT in treatment planning for pancreas carcinoma

Objective:To assess the relationship between 64-slice spiral CT findings and treatment planning for pancreas carcinoma.Methods:Thirty-five cases with pancreas carcinoma were analyzed retrospectively,which were all proved pathologically.The difference between CT and operation for respectable assessment were analyzed.And the relationship between the scanning technique and identification of the lesion was also studied.Results: Of the 35 cases,33(94%) were detected in the arterial phase,28(80%) in portal phase.The tumor in pancreas head were 25(71.4%),and in body and tail were 8(22.9%),2(5.7%).The diameter of the lesions was within 2.7-15cm,of which 13 cases was less than 3cm.Eignteen of 35 cases were evaluated preoperatively to be respectable by CT,and only 15 cases were recectable in operation.The accuracy assessed to be resectable by 64-slice CT was 83.3%.Conclusion: 64-sliceCT can detect small pancreas carcinoma whose diameter is less than 3cm,and CT angiography is especially good to show directly the relation of tumor with its adjacent vessels,and also good to find the eroded blood vessels.64-slice CT has an important role in staging tumors and evaluating the resectability of tumors.