胰腺癌；体层摄影术_X线计算机____

胰腺癌CT早期诊断的难点分析

http://www.100md.com 《中华现代影像学杂志》 2006年第8期

胰腺癌；体层摄影术,X线计算机,,],胰腺癌；体层摄影术，X线计算机,1资料与方法,2结果,3讨论,参考文献]

     [摘要] 目的分析胰腺癌早期CT诊断的难点。方法 15例经病理证实的小胰腺癌病例(男9例，女6例，平均年龄63岁)均行CT检查，6例行MR检查。分别对病变的大小、形态、密度及强化方式进行分析，同时评估胰管和胆管的扩张、胰腺的萎缩、转移灶的情况等。结果 15例病变中胰头8例，胰体4例，胰尾3例。病变大小1.2～2.0 cm，平均1.8 cm。13例病灶不均匀强化。平扫12例表现为等密度，3例低密度；动脉期11例为低密度，4例等密度；门脉期8例低密度，7例等密度。4例显示胆管扩张，5例胰管扩张。5例出现肝脏转移。初次CT诊断有5例出现误诊或漏诊。结论 CT对早期小的胰腺癌的诊断有一定的难度，优化扫描技术是提高诊断水平的关键。

    [关键词] 胰腺癌；体层摄影术，X线计算机

    Difficulties of CT diagnosis in early pancreatic adenocarcinoma

    ZHAO Dianhui,HUANG Junbin.Department of Radiology,Zhabei Central Hospital,Shanghai 200070，China

    [Abstract] Objective To analyse the difficulties of CT diagnosis in early pancreatic adenocarcinoma.Methods Fifteen cases(six women and nine men;mean age,63 years)with pancreatic adenocarcinoma,documented by pathologic examination of resected specimens,underwent CT(n=15)or MRI(n=6)examinations.The following data for each tumor:size,location,margination,internal density or signal intensity,and contrast enhancement pattern.In addition,we assessed the presence of pancreatic or bile duct dilation,atrophy of pancreas,and metastases.Results Masses were distributed throughout the pancreas(head,n=8;body,n=4;and tail,n=3).The mean largest dimensions were 1.8 cm(range,from 1.2 to 2.0 cm).thirteen masses enhanced homogeneously.Twelve lesions were isodensity and three were hypodensity before contrast.In artery phase eleven lesions were hypodensity and four isodensity.In venous phase eight were hypodensity and seven isodensity.Common bile and pancreatic duct dilatation was present in four and five patients,respectively.Five patient had metastatic liver disease at presentation.At the first examination five patients were misdianosed with CT.Conclusion It is a challenge to show the small pancreatic cancer with CT.The optimized scan technique is the key of diagnosis. ......

百拇医药网 http://www.100md.com/html/DirDu/2006/10/18/25/41/40.htm

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