多层螺旋CT判断壶腹周围癌的可切除性

目的:探讨多层螺旋CT(MSCT)判断壶腹周围癌可切除性的价值。材料和方法:回顾性分析经病理证实的35例壶腹周围癌患者的CT表现,并与手术或十二指肠胰胆管造影(ERCP)所见对照。结果:经MSCT检查35例均发现肿瘤,增强扫描肿瘤本身可见不同程度增强,其中16例经图像后处理,35例均清晰显示肿瘤及肿瘤与周围组织、血管的关系。根据MSCT表现判断26例肿瘤可手术切除,19例接受了肿瘤切除术,9例有转移或血管受累征象手术不能切除。结论:MSCT动态增强扫描与三维重建技术相结合能清晰地显示壶腹部肿瘤及其与周围结构的关系,对于壶腹周围癌可切除性的判断及预后有重要的指导作用。

The Contribution of Multi-slice Helical CT to Assess the Resectability of Periam Pullary Carcinoma

Purpose: To evaluate the value of MSCT in assessing the resectability of periampullary carcinoma. Materials and Methods: The MSCT films of 35 cases with periampullary carcinoma that had been proved by pathology were retrospectively reviewed and compared with the findings during operations or ERCP examinations. Results: On MSCT studies, tumors were found in the ampullary region in 35 cases and were enhanced in different degrees on the post-administration of iodine contrast iv, 16 of them were reconstructed. All these cases were shown definitely with neighbor tissues and vessles. By MSCT's assessment, 26 tumors were resectable, 9 tumors were unresectable because they had metastasized or invaded vessels. 19 tumors were resected. Conclusion: Using dynamic enhanced MSCT scan with 3D reconstruction, it can well display the tumors and the relationships with other tissues around them. MSCT plays an important role in assessing tumor resectability and predicting prognosis.