螺旋CT双期增强扫描对胰腺癌的诊断

为比较螺旋ＣＴ胰腺期和门脉期双期增强扫描在胰腺癌诊断和分期上的作用，对３６例胰腺癌患者行螺旋ＣＴ双期增强扫描，扫描延迟时间：胰腺期（ＰＰ）为３０ｓ，门脉期（ＰＶＰ）为６５ｓ，造影剂用量９５～１００ｍｌ，注射速度３ｍｌ／ｓ。结果显示正常胰腺组织增强值胰腺期和门脉期分别为７１．１０±１４．７９Ｈｕ和６１．０５±１０．４１Ｈｕ（Ｐ＜０．０５），肿瘤－胰腺对比胰腺期和门脉期分别为６１．２７±１５．４３Ｈｕ和５１．５±１９．７７Ｈｕ（Ｐ＜０．０５），肿瘤可切除性的ＰＰＶ为１００％，ＮＰＶ为７１．４３％，敏感性和准确性分别为９３．５５％和９４．４４％。表明螺旋ＣＴ双期增强扫描能更清晰地显示胰腺癌，胰腺期肿瘤－胰腺对比较门脉期更显著，同时还有利于肿瘤可切除性的估价及小胰腺癌的检出。

DUALPHASE HELICAL CT IN PANCREATIC CARCINOMA

To evaluate dualphase helical CT for detection and staging of pancreatic adenocacinoma, dualphase helical CT was performed on 36 patients with pancreatic adenocacinoma with a 95100ml bolus injection of contrast material at 3ml/s. Pancreatic phase(PP) and portal venous phase(PVP) began at 30 seconds and 65 seconds after the infusion of contrast material. The results showed that tumorpancreas contrast was significantly greater in PP(61.2715.43Hu) than in PVP(51.519.77Hu) (P<0.05), while mean value of pancereatic enhancement was 71.1014.79Hu in PP and 61.0110.41Hu in PVP (P<0.05). The enhancement values of major peripancreatic arterial structure were greater in PP than in PVP. The positive predictive values of the tumors was 100%, while the negative predictive values was 71.43%. The sensitivity and the accuracy were 93.55% and 94.44% respectively. Generally, dualphase helical CT could delineate pancreatic adenocarcinoma clearly. The tumorpancreas contrast was more conspicuous in PP than PVP. In addition, dualphase helical CT could afford more information for the assessment of resectability of pancreatic adenocarcinoma.