41例壶腹部恶性肿瘤的影像学诊断分析

【作者】 张弦；

【导师】 陈卫星；

【作者基本信息】 浙江大学 ， 消化内科， 2007， 硕士

【摘要】 目的：探讨B超、CT、MRCP、内镜下逆行性胆胰管造影(Endoscopic retrograde cholangiopancreatography，ERCP)等影像学方法在壶腹部恶性肿瘤的诊断方面的价值。方法：用回顾性研究的方法，搜集本院从2003年2月至2007年3月间经病理确诊的壶腹部恶性肿瘤病人共41例加以研究分析，比较B超、CT、MRCP、ERCP等影像学方法在这些病人诊断过程中的普及应用率及疾病的检出率。结果：我们把提示壶腹部占位的影像学印象作为检出的标准，可以发现，B超的应用率是最高的(100％)，所有的病人都做了腹部B超的检查，但检出率较低(26.83％)，ERCP作为有创检查，应用率较低(60.98％)，但检出率非常高(100％)。CT的应用率(95.12％)及检出率(84.62％)都较高，是良好的辅助手段。而MRCP由于定位效果良好，为ERCP治疗及手术治疗前最常用的辅助手段。结论：壶腹部的恶性肿瘤由于其临床特征多变且出现较晚，早期诊断困难，需多种影像学方法相结合，努力做到尽早诊断，争取手术时间和机会，改善病人的预后，提高生存率。更多还原

【Abstract】 Background: To evaluate the role of transabdominal ultrasound (US), computed tomography(CT),Magnetic Resonance Cholangiopancreatogra-phy(MRCP) and Endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis of the duodenal ampulla cancer.Methods: compile the 41 patients diagnosed to be duodenal ampulla cancer by pathology from Feb, 2003 to Mar, 2007 in our hospital to be retrospective study. Compare the pervasion rate and detection rate of US, CT, MRCP, ERCP in the diagnosis of these patients.Results: If we use "duodenal ampulla tumor" to be the standard imageology impress of detection, we can see that, US has the highest pervasion rate (100%) but the lowest detection rate (26.83%) .To be a traumato-examination, the pervasion rate of ERCP is the lowest(60. 98%), but it has the highest detection rate(100%). CT has both high pervasion rate (95.12%) and high detection rate (84.62 %) , so it is a favourable imaging examination. For the good role of the obstruct fixing, MRCP is always used to be the preoperative examination of ERCP or surgical intervention.Conclusion: For the fickle clinical feature and late appearance, the early diagnosis of duodenal ampulla cancer is hard. So we should use multiple imaging examinations and try our best to diagnose as early that strive the time and chance to surgical intervention and than improve the prognosis and survival rate of the patients.更多还原