胰腺癌瘤体强化程度与其恶性度的对照分析

目的探讨胰腺癌瘤体CT强化程度与其恶性度的关系。方法42例胰腺癌患者术前均行螺旋CT增强扫描,扫描延迟时间分别定为30s(胰腺实质期)、70s(门脉期)和180s(延迟期),以2.5～3.0ml/s速度团注对比剂100ml,观察胰腺癌胰实质期瘤体强化的程度和形式,结合胰腺癌病理组织学分级,对胰腺癌胰腺实质期的CT强化情况和病理级别作对照分析。结果胰腺高分化腺癌14例,平均胰腺-瘤体CT值差为(9.64±2.84)Hu,中分化腺癌16例,平均胰腺-瘤体CT值差(31.44±5.98)Hu,低分化腺癌12例,平均胰腺-瘤体CT值差(44.08±5.33)Hu,胰腺实质期病灶基本呈等密度强化13例,稍低密度强化15例,低密度强化伴小囊样改变9例,低密度强化伴大片坏死5例。胰腺癌实质期强化程度和形式与其病理分级有显著相关性,其秩相关检验结果为r=0.664(P<0.001)。结论胰腺癌实质期可以得到肿瘤的最大胰腺-瘤体密度差值,其瘤体强化程度和形式与其病理分级有显著相关性,即胰腺癌恶性度与其瘤体强化程度成反比。

A comparative analysis of CT enhancement degree and malignancy grade in pancreatic carcinoma

Objective To evaluate the relationship between CT enhancement degree and the malignancy grade in pancreatic carcinoma. Methods Enhanced helical CT was performed on 42 patients with pancreatic carcinoma before resection. Pancreatic phase and portal venous phase began at 30 s and 70 s after the start of injection, and delayed phase began at 180 s, with 100 ml intravenous contrast material injected at rate of 2.5-3.0 ml/s. The CT enhancement degree and pathological grade of tumor were comparatively analyzed in pancreatic phase of enhanced CT. Results Highly differentiated pancreatic adenocarcinoma was identified in 14 patients, and mean tumor-pancreas contrast was (9.64±2.84) Hu. Moderately differentiated tumor was in 16 patients, and mean tumor-pancreas contrast was (31.44±5.98) Hu, poorly differentiated tumor was in 12 patients, and mean tumor-pancreas contrast was (44.08±5.33) Hu. In pancreatic phase of enhanced CT, isodensity CT enhancement was demonstrated in 13 cases, slight hypodensity enhancement in 15 cases, slight hypodensity enhancement with small cyst lesion in 9 and slight hypodensity enhancement with large cyst lesion in 5 cases. The Results of correlation with CT enhancement degree and pathological grades of tumor were r=0.664 (P<0.001). Conclusion Excellent tumor-pancreas contrast is obtained with pancreatic phase scan. It is significant correlation between CT enhancement and pathological grades of tumor. The malignancy degree of tumor is inversely proportional to the extent of CT enhancement of tumor .