【摘要】 目的研究螺旋CT对早期胰腺癌的检查方法和诊断,以及对胰腺癌侵犯周围血管的判断。方法对28例胰腺癌行螺旋CT平扫及双期增强扫描,平扫层厚10.0mm,螺距为1,对病变部位重建为5.0mm层厚。强化采用高压注射器,非离子型造影剂,按体重1.5ml/kg。注射速度为2.5～3.0ml/s,层厚6mm,螺距为1,延迟35s和70s双期扫描,并行血管三维重建。结果28例均显示胰腺肿块,其中肿块<2cm者5例(18%),SCT平扫28例中肿块呈等密度者3例(10.7%),而该3例肿块中有2例≤2cm,强化延时35s扫描,20例肿块无明显强化,8例轻度强化。26例肠系膜上静脉受压移位及脂肪间隙模糊或消失,16例肿块包绕肠系膜上静脉半周以上,经最大密度三维血管重建显示肠系膜上静脉狭窄、扭曲及充盈缺损者15例,门静脉狭窄者1例。结论①螺旋CT平扫及双期扫描强化有利于早期胰腺癌的检出。②螺旋CT多层面重建及三维血管重建提高了判断胰腺癌侵犯周围血管的准确性。更多还原

【Abstract】 Objective To study the exam methods and diagnostic value for early-phase pancreatic cancer by spiral CT, and to evaluate the condition of vessels around tumor. Methods The plain and dual-phase enhanced CT scanning of pancreas in 28 patients were carried out. Initially, the plain scanning with 10 mm collimation was carried out. Subsequently a rapid infusion was given intravenously with a power injector. The contrast material dose was 1.5ml/kg body weight injection with the 2.5~3.0ml/s,and then preformed the dual-phase enhanced CT scanning. The collimation was 6mm,and the delay time was 35s and 70s. After dual-phase enhanced scanning, three-dimensional reconstructive imaging of vessels was obtained. Results Pancreas tumors have been displayed in all 28 patients. Only 5 cases were exhibited tumor size <2cm.The plain scanning displayed, isodense of tumor in 3 cases, and 2 of 3 demoostiated tumor size <2cm. Scanning after 35s of infusion showed that no significantly enhanced were 20, slightly enhanced were 8, the figure of pancreas abnormal and the fat gap surrounding pancreas was blur or disappear were 16, different degree obstruction of cystic duct were 27, the superior trated the superior mesenteric vein stenosis, distortion, and filling detect were 15, portal vein stenosis were 1. Conclusion ①Plain and dual-phase enhanced scanning of spiral CT may provide significant diagnostic information for early-phase pancreatic cancer. ②The vessels invaded could be estimated more correct by multiplanar reconstructions and 3-D reconstruction.更多还原