摘要
目的总结胰腺腺鳞癌的多排螺旋CT（MSCT）检查特征。方法本研究回顾性分析2011年2月至2013年8月宁波大学医学院附属医院收治的3例和第二军医大学附属长海医院收治的16例胰腺腺鳞癌患者的临床资料。患者行MSCT平扫＋增强扫描，结果行多平面重建。观察肿瘤部位、大小、形态、密度、强化模式、继发表现、侵犯和转移等情况。患者行手术治疗，术后行病理学检查包括大体、组织形态学观察、HE染色和免疫组织化学染色检测。术后通过门诊复查或电话对患者进行随访，随访时间截至2014年8月31日。正态分布的计量资料以x±s表示，组间比较采用t检验。结果（1）肿瘤位于胰头部10例、胰颈部1例、胰体部3例、胰尾部1例，肿瘤同时位于胰体部、胰尾部4例；15例肿瘤突出胰腺轮廓，4例肿瘤与胰腺边缘平直。13例肿瘤为类圆形和卵圆形，6例为不规则形。肿瘤的直径为（3．7±1．9）cm（2．0～8．0cm），胰头、颈部肿瘤直径为（2．8±0．9）cm，小于胰体、尾部肿瘤直径的（4．9±2．2）CM，两者比较，差异有统计学意义（t=－2．543，P〈0．05）。（2）15例肿瘤瘤体平扫呈低密度或稍低密度，4例呈等密度。9例肿瘤瘤体内发生坏死、囊变，10例为实性组织。19例肿瘤瘤体均未见出血、钙化。肿瘤实性组织平扫CT值为（36±10）HU。（3）9例肿瘤瘤体呈Ⅱ型强化，5例呈Ⅳ型强化，2例呈Ⅲ型强化，类似“蜂窝样”表现，2例综合表现为Ⅲ型＋Ⅳ型，1例呈I型强化。肿瘤实性组织动脉期、胰腺实质期、门静脉期及平衡期的CT值分别为（45±9）HU、（55±9）HU、（56±11）HU、（51±15）HU。（4）15例肿瘤引起主胰管扩张，7例胰头部肿瘤引起胆管扩张，3例引起胰腺萎缩，11例并发急性胰腺炎，2例并发脾脏梗死。9例肿瘤侵犯周围组织器官，8例发生淋巴结转移，2例发生肝脏转�
Objective To summarize the features of multi-slice spiral computed tomography （MSCT） examination for pancreatic adenosquamous carcinoma. Methods The clinical data of 19 patients with pancreatic adenosquamous carcinoma who were admitted to the Affiliated Hospital of Ningbo University Medical School and Changhai Hospital from February 2011 to August 2013 were retrospectively analyzed. All the patients received plain and enhanced scan of CT, and the data were transported to the work station for multiplanar reconstruction. The location, size, shape, density, enhancement pattern of tumor, secondary performance, invasion and metastasis were observed. All the patients received operative treatment and postoperative pathological examinations including observations of gross morphologic and histomorphology, HE staining and immunohistochemistry. All the patients were followed up by outpatient examination and telephone interview till 31 August, 2014. Measurement data with normal distribution were presented as x ± s, and comparison between groups was analyzed by the t test. Results （ 1 ） Ten tumors were located in the pancreatic head, 1 in the pancreatic neck, 3 in the body of pancreas, 1 in the tail of the pancreas and 4 in the body and tail of the pancreas. Tumors of 15 patients showed exophytic growth and tumors of 4 patients showed pancreas straight edges. Tumors were round-like or ellipse shape in 13 patients and irregular shape in 6 patients. The maximum diameter of tumors was （3.7 ± 1.9） cm （ range, 2.0-8.0 cm）. The diameter of tumor in the pancreatic head and neck was （2.8 ± 0.9） cm, which was significantly different from （4.9 ±2.2） cua in the body and tail of pancreas （ t = - 2. 543, P 〈 0.05）. （2） Plain CT scan showed that tumors demonstrated low density or slightly low density in 15 patients, isodensity in 4 patients. Nine tumors had necrosis and cystic area, and 10 tumors were solid. There was no hemorrhage and calcinosis in 19 patients. The value of plain CT scan of solid tumo
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第8期677-682,共6页
Chinese Journal of Digestive Surgery
基金
国家自然科学基金（81170435、81471714、30570535）
中国博士后科学基金（20100480545）
上海市国际科技合作基金（10410708800）
浙江省自然科学基金（LYl3H070008）
浙江省医药卫生科技计划项目（2014KYB238、2013KYAl82、2012KYBl76）
宁波市自然科学基金（2013A610256、2010A610052、2015A610201）
关键词
胰腺肿瘤
腺鳞癌
体层摄影术
X线计算机
Pancreatic neoplasms
Adenosquamous carcinoma
Tomography, X-ray computed
