CT在判断可切除性胰头癌手术中的价值探讨

经手术、病理证实的胰头癌５９例。通过对术前ＣＴ判断肿瘤的可切除性和术后比较，其结果可切除的符合率为６４．７％，不可切除的符合率为９２．８％。ＣＴ显示肠系膜上动脉、腹腔动脉增粗，肿瘤包裹血管、血管中癌栓形成为肿瘤不可切除的可靠征象；肝转移、腹水为不可切除的完全可靠的征象，但小的转移性肝癌不易发现；淋巴结肿大并不是转移的特异征象；血管部分与肿瘤接触，脂肪层消失，有时不易区别是否为肿瘤授润，对判断手术可

Value of CT in assessing resectability of pancreatic head carcinoma

This article reviewed 59 cases of pancreatic head carcinomas(all proved surgically and pathologically).Comparison between preoperative CT assessment of tumor resectability and postoperative results revealed a 92.8% of comformity for unresectability and 64.7% for resectability.Emphasis was laid on the discussion of the value of para-pancreatic great vessel involvement and lymph-node or liver metastasis in the assessment of tumor resectability. Enlargement of superior mesenteric artery(SMA) and celiac artery(CA),tumor-encased vessels and intra-vascular tumor thrombosis were relatively reliable CT findings for unresectability,and presentation of liver metastasis and ascites were most reliable findings for unresectability-though small liver metastasis was difficult to detect.Lymph-node enlargement was not a specific sign of metastasis.It was not easy to determine whether tumor contact with vessels and disappearance of fat layers were the results of tumor infiltration,which was less reliable in assessing resectability.