经动脉插管双期螺旋CT扫描评价胰头癌的可切除性

目的：采用经动脉插管双期螺旋CT扫描的方法，对胰头癌的可切除性进行评价。方法；对18例胰头癌行经动脉插管后双期螺旋CT增强扫描，动脉期扫描时间为10s，门静脉期50s，扫描速度2.5ml/s，造影剂为欧乃派克300或优维显30030ml，用0．9％生理盐水稀释至100ml，通过留置导管注入造影剂于肠系膜上动脉。扫描结果和经静脉双期扫描进行对比。结果：18例胰头癌，可行根治切除3例，不可根治切除15例。对于3例可行根治切除的，两种方法均做出了正确判断，15例不可根治手术者经动脉插管双期螺旋CT扫描作出了正确判断，而经静脉双期扫描只正确判断了12例。估计手术无法切除率经动脉双期扫描为83％（15／180，经静脉双期扫描为67％（12／18）。在判断胰周血管是否受侵的准确性方面，经动脉插管法优于静脉法。结论：经动脉插管双期螺旋CT扫描能够较经静脉双期扫描更准确地评价胰头癌的情况，有利于肿瘤可切除性的评价。

Assessing the resectability of pancreatic head cancer with catheterized arterial dual-phase spiral CT enhancement

Objective:To evaluate dual phase spiral CT scanning enhancement via arteries in assessing the resectability of pancreatic head cancer.Methods:Tumor resectability was prospectively evaluated in 18 patients proven pancreatic head cancer.The results of dual phase spiral CT scanning enhanced via arteries and those enhanced via veins were compared.Results:Fifteen of 18 patients had nonresectable disease,while three had resectable tumor,both dual phase spiral CT scanning enhanced via arteries and via veins were correct in assessing the resectability.Spiral CT scanning enhanced via arteries correctly predicted all the nonresectable cases and enhanced via veins only correctly predicted 12 cases.In assessing vascular involvements,dual phase spiral CT scanning enhanced via arteries showed superiority to that enhanced via veins.Conclusion:Dual phase spiral CT scanning enhanced via arteries is superior to that via veins in assessing the resectability of pancreatic head cancer.