术前CT评估胰头癌可切除性的意义

目的评价术前CT判别胰头癌可切除性的方法和标准，并评估其临床意义。方法使用螺旋CT对24例胰头癌病人进行术前薄层多期扫描，将胰周血管受侵犯程度分为4级，结合周围组织脏器的受累情况判断胰头癌的可切除性，并与手术结果相对照。结果24例胰头癌病人，术前15例判别可切除，实际14例得到了根治性切除，阳性准确率达93．3％，阴性准确率达100％。结论利用血管受侵犯程度分级，螺旋CT可以较准确的判别胰头癌的可切除性，具有重要的临床意义。

Value of helical computed tomography for preoperative evaluation of resectability of pancreatic head carcinoma

Objective To assess the value of helical computed tomography(HCT)for preopera- tive evaluation of resectability of pancreatic head carcinoma.Methods Preoperative HCT scanning was performed in 24 patients with pancreatic head carcinoma.Thin section three-phase scans com- posed of plain scans and artery-vein scans were obtained by using contiguous 3-mm collimated slices. Peripancreatic vessels were prospectively graded on a 0-3 scale based on circumferential contiguity of tumor to vessels.Combining the degree of contiguous organ invasion together,the preoperative pre- diction of resectability of the tumor was made.Surgical results were then compared with those of CT scanning.Results Fifteen of the 24 cases of pancreatic head carcinoma were judged to be potentially resectable on the basis of HCT.Fourteen patients underwent radical resection.The judging accuracy of preoperative resectability was 93.3%.Conclusions Taking advantage of strong point of CT grades of vascular invasion,the resectability of pancreatic head carcinoma can be accurately predicted with HCT preoperatively.This method is helpful in clinical practice.