目的 胰腺占位用平扫与增强所扫描出的图像,在诊断中提供的参考价值有哪些区别。方法 搜集南京中医药大学沭阳附属医院(沭阳县中医院)就诊行CT腹部检查的63例患者的平扫与增强的CT表现。分析病灶的血供、密度、境界、周围血管的侵犯、周围血管腔的癌栓、周围淋巴结的显示以及病灶检出率。结果 在63例病例中,其中胰腺癌43例,胰腺囊肿10例,胰腺内分泌性肿瘤5例,浆液性囊腺瘤5例。CT平扫35例,检出率85.71%(30/35);增强28例,检出率100%(28/28),增强的检出率明显高于平扫检出率,并提供血供显示,周围血管受侵情况,血管内是否有癌栓,周围淋巴结的显示及强化情况。结论 CT增强比平扫能提供更多的诊断信息,并能为临床手术方法、范围等提供依据。
Objective To discuss diagnostic difference of pancreatic lesion by using CT scan and CT enhancement.Methods A toal of 63 patients from Shuyang Hospital Affiliated to Nanjing University of Traditional Chinese Medicine (Shuyang Hospital of Traditional Chinese Medicine) underwent CT scan and CT enhancement of abdomen.The images of blood supply, density, boundary, invasion of surrounding blood vessels, vascular cancer embolus, and surrounding lymph nodes as well as the detection rate of pancreatic lesion were analyzed.Results Among the 63 cases, there were 43 cases of pancreatic cancer, 10 cases of pancreatic cyst, 5 cases of pancreatic endocrine tumor, and 5 cases of serous cystadenoma.The detection rate of pancreatic lesion by CT scan(85.71% [30/35]) was significantly lower than that by CT enhancement(100% [28/28]).In addition, CT enhancement provided images of blood supply, invasion of surrounding blood vessels, vascular cancer embolus, and images and intensity surrounding lymph nodes.Conclusion CT enhancement can provide more diagnostic information for operation than CT scan.
[1] 叶乔,陈柯,刘倩倩,等.超声内镜引导下细针穿刺结合巴氏细胞学分级诊断胰腺实性病变的价值[J].中华消化杂志, 2017,12(37):823-827.
[2] Siegel RL, Miller KD, Jemal A.Cancer statistics[J].CA Cancer J Clin, 2017,67(1):7-30.
[3] Manning MA, Srivastava A, Paal EE, et al.Nonepithelial neoplasms of the pancreas: radiologic-pathologic correlation. Part 1—benign tumors: from the radiologic pathology archives[J].Radio Graphics,2016,36(1):123-141.
[4] 石明国.医用影像设备(CT/MR/DSA)成像原理与临床应用[M].北京:人民卫生出版社. 2013:217.
[5] Kim JH, Park SH, Yu ES, et al.Visually isoattenuating pancreatic adenocarcinoma at dynamic-enhanced CT: frequency, clinical and pathologic characteristics, and diagnosis at imaging examinations[J].Radiology, 2010,257(10):87-96.
[6] Scialpi M, Pierotti L, Piscioli I, Brunese L, et al.Detection of small (≤20 mm) pancreatic adenocarcinoma: histologic grading and CT enhancement features[J].Radiology, 2012,262(3):1044-1045.
[7] Kucera JN, Kucera S, Perrin SD, et al.Cystic lesions of the pancreas: radiologic-endosonographic correlation[J].Radio Graphics, 2012,32(11):283-301.
[8] Gallotti A, Johnston RP, Bonaffini PA, et al.Incidental neuroendocrine tumors of the pancreas: MDCT findings and features of malignancy[J].AJR Am J Roentgenology, 2013,200(10):355-362.
