低张饮水后螺旋CT增强对乳头型壶腹癌的诊断价值

目的探讨低张后螺旋CT增强对乳头型壶腹癌的诊断价值。方法对20例经手术病理证实的乳头型壶腹癌其CT表现进行回顾性分析,采用低张(肌注654-220mg)后饮水(300～500ml)行螺旋薄层CT增强扫描,侧重观察动脉期表现。结果20例常规平扫仅2例在胰腺钩突水平十二指肠降段靠内侧区似有类圆形肿块所致的充盈缺损,18例均未见明确病灶,低张饮水后薄层增强所有病例均显示局限性明显或不均一强化之充盈缺损影,肿块直径0.8～2.6cm;2例伴有胰头钩突受侵,肿块直径2.4～2.6cm,2例十二指肠周围淋巴结转移。所有病例均显示肝内胆管扩张、胆囊增大和胆总管扩张。结论低张饮水后螺旋CT增强较常规增强扫描在确定肿瘤大小、形态等方面更具优越性。

Diagnosis of Papillary Carcinoma of Ampulla by Contrast -Enhanced Spiral CT after Low Tension and Drinking Water

Objective To explore the diagnostic value of contrast-enhanced spiral CT after low tension and drinking water in papillary carcinoma of ampulla. Methods CT manifestations of papillary carcinoma of ampulla comfirmed pathologically in 20 cases were analysed retrospectively emphasized in artery phase on contrast CT which was performed after injecting 654-2 20 mg and drinking 300~500 ml water.Results Of all the cases , only 2 cases showed tumor filling defect in the descending part of duedenum nearby pancreas on routine CT, but all the cases showed more or less tumor filling defect on contrast-enhanced spiral CT . The diameters of the tumor were between 0.8 to 2.6 cm,2 cases with head of pancreas affected,the diameters of the tumor were between 2.4 to 2.6 cm.There were 2 cases with lymph node metastasis nearby duedenum.All the cases showed expansion of gallbladder ,intrahepatic duct and choledochus expanding in the liver. Conclusion Contrast-enhanced spiral CT after low tension and drinking water is superior to routine CT in determining the size and morphosis of tumor.