128层螺旋CT在胰腺癌诊断中的价值
2022-06-09
[摘要] 目的 探讨128层螺旋CT三期动态扫描及图像后处理技术运用在胰腺癌诊断及手术评估中的价值。 方法回顾性分析我院2010～2013年13例经手术、病理、临床证实的胰腺癌CT扫描方式及CT征象、影像诊断与临床结果对比，从而分析128层螺旋三 期动态扫描方法运用及图像后处理技术对胰腺癌的诊断价值。 结果 全部13例患者均进行三期动态增强扫描。13例患者肿瘤位于胰头及钩突部9例、胰颈部2例、体尾部2例。平扫等密度7例、稍低或低密度6例。1 例病灶包埋肠系膜上动脉。5例可见主胰管扩张、2例见双管征。2例见肝内外胆管扩张。腹主动脉旁淋巴结肿大2例。合并转移瘤2例。5例手术证实，8例临床 证实。 结论 128层螺旋CT三期动态扫描及图像后处理技术运用结合可提高胰腺癌诊断准确率及手术评估中的价值。
[关键词] 胰腺癌；三期动态扫描
[中图分类号] R735.9；R814.42 [文献标识码] B [文章编号] 1673-9701（2015）04-0096-03
[Abstract] Objective To investigate the application value of 128-slice spiral CT three-stage dynamic scanning and image post-processing techniques for the diagnosis and surgical evaluation of pancreatic cancer. Methods The CT scanning modes， CT signs， imaging diagnosis and clinical results of 13 patients with pancreatic cancer confirmed by surgical， pathological and clinical results in our hospital from 2010 to 2013 were analyzed retrospectively. The diagnostic value of 128-slice spiral three-stage dynamic scanning modes and imaging post-processing techniques for pancreatic cancer was analyzed. Results All 13 patients received three-stage dynamic enhancement scanning. Of the 13 patients， 9 patients had tumor located in pancreatic head and unciform process， 2 patients in pancreatic neck and 7 patients in body and tail. Seven patients showed equidensity and 6 patients showed slightly low or low density in plain scan. One patient had superior mesenteric artery embedded by lesion. Main pancreatic duct expansion was observed in 5 patients and double duct sign was observed in 2 patients. Intrahepatic and extrahepatic bile duct dilation was observed in 2 patients. Para-aortic lymph node enlargement was observed in 2 patients. Complicating metastatic tumor was observed in 2 patients. Five patients were confirmed surgically and 8 patients were confirmed clinically. Conclusion The combined application of 128-slice spiral CT three-stage dynamic scanning and image post-processing techniques can improve the diagnostic accuracy for pancreatic cancer and the value for surgical evaluation.
[Key words] Pancreatic cancer； Three-dynamic scan
胰腺癌是消化系统常见恶性肿瘤之一，预后差、死亡率高、五年生存率低[1]。提高生存率、改善预后的关键是尽量早发现、明确病变性质和范围以及病变和周围 组织、血管的解剖关系，从而选择科学、合理的治疗方案。作者选择我院2010～2013年期间13例经手术、病理、临床证实的胰腺癌进行影像诊断与临床结 果对比，分析128层螺旋三期动态扫描方法运用的价值及胰腺癌的CT征象、图像后处理技术对胰腺癌的诊断、治疗价值，旨在提高胰腺癌诊断水平，给临床诊治 提供更多信息。
1 资料与方法
1.1临床资料
收集我院近期13例行CT检查的胰腺癌患者，其中男8例、女5例。年龄41～71岁，平均61.2岁。主要临床表现有中上腹疼痛、消瘦、乏力、黄疸。
1.2 扫描方法
检查前禁食8 h、扫描前30 min口服1.5%碘水500 mL、采用128层西门子螺旋CT行胰腺平扫+胰腺三期动态扫描。扫描时间为动脉期30 s、胰腺期45 s、门脉期75 s。高压注射器经肘静脉以3.5 mL/s注射，扫描完成后在工作站重建、后处理。
2 结果
全部13例患者均行三期动态增强扫描，肿瘤位于胰头及钩突部9例、胰颈部2例、体尾部2例。直接征象：肿块平扫等密度7例、稍低或低密度6例。增强后13 例病灶出现了不同程度的不均匀强化。边缘模糊、中心低密度[2]。动脉期低密度病灶与动脉血管对比显示佳。胰腺期病灶显示清楚。门静脉期肝脏增强明显，发 现合并转移瘤2例。间接征象：胰腺轮廓明显改变11例。3例病灶与周围血管分界不清，其中1 例动脉期可见病灶包埋肠系膜上动脉。5例可见主胰管扩张、2例见双管征。2例见肝内外胆管扩张。腹主动脉旁淋巴结肿大2例。5例手术证实，8例临床证实。
3 讨论
3.1 扫描方法
[关键词] 胰腺癌；三期动态扫描
[中图分类号] R735.9；R814.42 [文献标识码] B [文章编号] 1673-9701（2015）04-0096-03
[Abstract] Objective To investigate the application value of 128-slice spiral CT three-stage dynamic scanning and image post-processing techniques for the diagnosis and surgical evaluation of pancreatic cancer. Methods The CT scanning modes， CT signs， imaging diagnosis and clinical results of 13 patients with pancreatic cancer confirmed by surgical， pathological and clinical results in our hospital from 2010 to 2013 were analyzed retrospectively. The diagnostic value of 128-slice spiral three-stage dynamic scanning modes and imaging post-processing techniques for pancreatic cancer was analyzed. Results All 13 patients received three-stage dynamic enhancement scanning. Of the 13 patients， 9 patients had tumor located in pancreatic head and unciform process， 2 patients in pancreatic neck and 7 patients in body and tail. Seven patients showed equidensity and 6 patients showed slightly low or low density in plain scan. One patient had superior mesenteric artery embedded by lesion. Main pancreatic duct expansion was observed in 5 patients and double duct sign was observed in 2 patients. Intrahepatic and extrahepatic bile duct dilation was observed in 2 patients. Para-aortic lymph node enlargement was observed in 2 patients. Complicating metastatic tumor was observed in 2 patients. Five patients were confirmed surgically and 8 patients were confirmed clinically. Conclusion The combined application of 128-slice spiral CT three-stage dynamic scanning and image post-processing techniques can improve the diagnostic accuracy for pancreatic cancer and the value for surgical evaluation.
[Key words] Pancreatic cancer； Three-dynamic scan
胰腺癌是消化系统常见恶性肿瘤之一，预后差、死亡率高、五年生存率低[1]。提高生存率、改善预后的关键是尽量早发现、明确病变性质和范围以及病变和周围 组织、血管的解剖关系，从而选择科学、合理的治疗方案。作者选择我院2010～2013年期间13例经手术、病理、临床证实的胰腺癌进行影像诊断与临床结 果对比，分析128层螺旋三期动态扫描方法运用的价值及胰腺癌的CT征象、图像后处理技术对胰腺癌的诊断、治疗价值，旨在提高胰腺癌诊断水平，给临床诊治 提供更多信息。
1 资料与方法
1.1临床资料
收集我院近期13例行CT检查的胰腺癌患者，其中男8例、女5例。年龄41～71岁，平均61.2岁。主要临床表现有中上腹疼痛、消瘦、乏力、黄疸。
1.2 扫描方法
检查前禁食8 h、扫描前30 min口服1.5%碘水500 mL、采用128层西门子螺旋CT行胰腺平扫+胰腺三期动态扫描。扫描时间为动脉期30 s、胰腺期45 s、门脉期75 s。高压注射器经肘静脉以3.5 mL/s注射，扫描完成后在工作站重建、后处理。
2 结果
全部13例患者均行三期动态增强扫描，肿瘤位于胰头及钩突部9例、胰颈部2例、体尾部2例。直接征象：肿块平扫等密度7例、稍低或低密度6例。增强后13 例病灶出现了不同程度的不均匀强化。边缘模糊、中心低密度[2]。动脉期低密度病灶与动脉血管对比显示佳。胰腺期病灶显示清楚。门静脉期肝脏增强明显，发 现合并转移瘤2例。间接征象：胰腺轮廓明显改变11例。3例病灶与周围血管分界不清，其中1 例动脉期可见病灶包埋肠系膜上动脉。5例可见主胰管扩张、2例见双管征。2例见肝内外胆管扩张。腹主动脉旁淋巴结肿大2例。5例手术证实，8例临床证实。
3 讨论
3.1 扫描方法