螺旋CT双期扫描对胰腺癌可切除性的评价

目的 评价螺旋ＣＴ双期扫描对胰腺癌可切除性的价值。材料与方法 对４２例拟诊胰腺癌随后又行手术治疗的患者作出前瞻性的诊断和可切除性的评估。病理结果：胰腺癌３３例，非胰腺癌９例。ＣＴ双期延迟扫描时间分别为２５ｓ和６０ｓ。并将ＣＴ判断的结果与手术结果作对比。结果 ４２例中，螺旋ＣＴ正确诊断３９例（９３％）。螺旋ＣＴ判断可切除性的敏感性为８９％，牧场划性为９２％，准确性为９１％。１０例肝转移癌，ＣＴ诊断８

Assessment of Resectability of Pancreatic Cancer with Dual-Phase Spiral CT

Objective To evaluate dual phase spiral CT scanning in assessing the resectability of pancreatic cancer.Materials and Methods The resectability and diagnosis were prospectively evaluated in 42 patients with suspicious pancreatic cancer who underwent surgery later. Pathologic results confirmed pancreatic cancer in 33 cases and not confirmed pancreatic cancer in 9 cases. Dual phase CT scans were obtained with the delayed time of 25 or 60 seconds, respectively. A comparison of CT diagnosis with surgical findings was made.Results Of total 42 cases, 39 (93%) were correctly diagnosed on spiral CT. For prediction of resectability, spiral CT carries an accuracy of 91%, sensitivity of 89% and specificity of 92%. CT detected liver metastases in 8 of 10 cases (80%) and peritoneal carcinomatosis in 5 of 9 cases (56%), and correct judgement as whether the peripancreatic vessels were invaded was obtained in 19 of 21 cases (91%).Conclusion (1) Spiral CT scanning exhibits high accuracy both in diagnosing pancreatic cancer and in assessing the peripancreatic vascular invasion, therefore, it is the most valuable and precise imaging technique for preoperative assessment of pancreatic cancer. (2) Dual phase thin slice spiral CT scanning can accurately assess the peripancreatic vessels, though it has limited value in detecting small liver metastases and peritoneal carcinomatosis.