乳头型壶腹癌螺旋CT双期增强的表现

目的 了解螺旋CT双期增强扫描显示乳头型壶腹癌的CT表现。方法 回顾性分析15例手术病理证实的乳头型壶腹癌的CT表现，螺旋CT采用薄层双期（动脉和门脉）增强扫描，动脉期扫描采用层厚5mm，螺距1．0；门脉期扫描层厚和间隔均为5mm。结果 螺旋CT动脉和门脉增强扫描，15例均清晰显示十二指肠乳头部局限性强化的充盈缺损块影，肿瘤瘤径为1－5cm，平均2．3cm。所有病例均可见虢人胆管扩张、胆囊增大、胆总管扩张和胰腺管的扩张，仅有1例伴胰体尾部的明显萎缩。结论 螺旋CT双期增强扫描不仅能准确确定梗阻的平面，还能显示十一指肠乳头部过来腹癌强化的肿块影，这对诊断乳头型壶腹癌是关键的CT征像。

Enhanced dual-phase spiral CT features of polypoid ampullary carcinoma

Objective　To understand CT features of polypoid ampullary carcinoma by enhanced dual-phase spiral CT.Methods　15 cases of polypoid ampullary carcinoma (PAC) confirmed by surgical and pathological results were studied with thin slice enhanced dual-phase spiral CT (including arterial and portal phase scanning)with retrospective analysis, the scanning parameters were 5 mm thickness and 1.0 pitch for arterial phase scanning , and 5 mm thickness and 5 mm space for portal phase scanning. Results　All cases could display an enhanced mass as local filling defect at the site of the duodenal Vater′s ampulla during arterial and portal phase scanning, the tumors ranged in size from 1 cm to 5 cm with mean of 2.3 cm, all were accompanied with dilated intrahepatic and common bile duct, enlarged gallbladder and dilated pancreatic duct, except one case which had marked atrophy of the pancreatic body and tail. Conclusion　The thin slices enhanced dual-phase spiral CT could not only accurately define the level of obstruction,but also demonstrate an enhanced mass as direct CT sign of the PAC, which is crucial for diagnosis of the PAC.