胰头癌SCT表现与手术病理对照分析

目的探讨螺旋CT扫描对胰共癌诊断的价值,提高SCT对胰头癌诊断的准确性。方法分析我院1998年7月-2004年2月经手术、病理证实的胰头癌25例,其中24例为腺癌,1例为囊腺癌。将SCT表现与手术、病理和临床特征进行回顾性分析并用统计学处理。结果胰头癌增强扫描均呈低密度。19例胆内胆管呈软藤状重度扩张。19例肝内外胆管成比例扩张,分别有22例和10例伴有胰管扩张和“双管征”,24例胆总管环影数在4-6个之间,15例伴有胰腺体、尾部的萎缩,15例侵犯邻近血管。结论SCT双期增强扫描在胰头癌的诊断中具有重要价值。且可对肿瘤的可切除性作出术前评价。

Comparative Analysis of the Carcinoma of Pancreatic Head Between SCT Findings and Surgery or Pathology

Objective To evaluate the value of spiral CT scan in the diagnosis of the carcinoma of pancreatic head and to improve the accurate rate of the diagnosis of the carcinoma of pancreatic head by CT scan.Methods Twenty-five cases of the carcinoma of pancreatic head proved by surgery or pathology from 1998 July to 2004 February were analyzed.There were 24 cases of adenocarcinoma and 1 case of adenocystic carcinoma.The results of these cases were analyzed retrospectively with the spiral CT findings and the clinical characteristic according to surgery and/or pathology using SPSS.Results All cases of the carcinoma of pancreatic head showed lower density after enhancement.There were 18 cases with dilated pancreatic duct,10 cases with "dual-duct sign",22 cases with 4 to 6 rings of dilated common bile duct,15 cases with the atrophy of pancreatic body and tail.The common bile duct of 21 cases and the intrahepatic bile duct of 19 cases were media or heavy-degree dilation.The dilated intrahepatic bile duct of 19 cases was proportional with dilated extrahepatic one.All associated with dilated gallbladders.Conclusion Spiral CT dual-phase scan is an evexamination modality in the diagnosis of the carcinoma of pancreatic head and using SCT scan predicts whether tumors are resectable before surgery.