多排螺旋CT曲面重建在胰腺和胰周病变中的应用

目的　探讨多排螺旋CT曲面重建在胰腺及胰周病变中的应用价值。方法　对胰腺和胰周病变的患者共 17例采用多排螺旋CT扫描上腹部 (5例单纯平扫 ,11例平扫 增强 ,1例行静脉CT胆道造影 ) ,其中胰腺癌 4例 ,胆总管结石 3例 ,慢性胰腺炎伴假性囊肿 3例 ,真性囊肿合并慢性胰腺炎及胆道梗阻 1例 ,囊腺瘤 1例 ,胰岛细胞瘤 1例 ,胰周淋巴结肿大 3例和 1例脾动脉瘤。由操作者经特定的解剖结构和病变画线做曲面重建。结果　多排螺旋CT可获得高质量的曲面重建图像 ,跟踪显示胰胆管或胰周血管 ,和清晰显示病灶与胰腺、胰胆管和胰周血管的关系。结论　多排螺旋CT薄层扫描能获得胰腺高质量曲面图像 ,提供独特的解剖信息和相关病理征象 ,有助于胰腺和胰周病变的诊断及局部侵犯的评价 ,指导临床治疗方案的选择与实施。

The Application of Curved Planar Reconstruction Using Multidetector Spiral CT in Pancreatic and Peripancreatic Lesions

Objective To assess the value of curved planar reconstruction using multidetector spiral CT in diagnosis of pancreatic and peripancreatic lesions. Methods Curved planar reconstruction on special anatomy and lesions after scanning by multidetector spiral CT was performed in 17 patients with pancreatic or peripancreatic diseases.Five patients underwent plain scan and 11 patients underwent both plain and contrast-enhanced scan, while one patient with CT cholangiography. The diseases included pancreatic carcinoma (n=4), cystadenoma (n=1), insulinoma (n=1), choledocholithiasis (n=3), chronic pancreatitis with pesudocyst (n=3), real cyst complicated with chronic pancreatitis and bile duct obstraction (n=1), peripancreatic adenopathy (n=3) and spleen arterial aneurysm (n=1).Results Using multidetector spiral CT, curved planar reconstruction with high quality could be obtained to trace the cholangiopancreatic duct or peripancreatic vessels, and to show the relationship of the lesions with pancreas and peripancreatic anatomy clearly.Conclusion Multidetector spiral CT with thin collimation could be used to create high-quality curved planar reformations of pancreas with unique anatomic information and relative pathologic signs, which is helpful in diagnosis and evaluating the local involved of pancreatic and peripancreatic lesions, and providing advice for clinics in making therapeutic programs.