摘要
目的：探讨壶腹周围癌的ＣＴ表现及其诊断价值。材料和方法：分别选取经手术和／或病理证实的壶腹周围癌２３例，其中胆总管远端癌６例，胰头钩突癌（直径≤３ｃｍ）７例，壶腹癌８例，十二指肠乳头部癌１２例。着重分析该部位肿瘤所共有ＣＴ直接与间接征象以及各种不同肿瘤的特征性ＣＴ表现，并与ＵＳ、ＥＲＣＰ、ＰＴＣ等影像技术进行比较。结果：壶腹周围癌的直接ＣＴ征象为胰头钩穷区、胆总管远端或十二指肠乳头部的软组织块影，显示率达９１．３％．胰头钩突癌的特征性ＣＴ表现为扩张的胆总管与主胰管（双管征）间距增宽。胆总管远端癌则表现为扩张的胆总管内结节及肿块与胆总管间无界面。十二指肠乳头部癌与壶腹癌二者不易区别，十二指肠腔内缺损及合一的双管征则是典型表现。本组术前ＣＴ定性诊断符合率达８６．９％。结论：运用ＣＴ检查诊断壶腹周围癌是有效而准确的方法。
To evaluate the value of CT scan in diagnosing periampullar cancer. Materials and Methods : 23 cases of periampullar cancer proved by operation and pathology are selected,including primary distal cholangiocarcinoma (6cases), carcinoma of uncinate process of pancreas (7cases) (diameter≤3cm), carcinoma in the region of Vater's ampulla (8 cases) and carcinoma of papilla duodeni major (2 cases).This paper emphatically analysed the CT direct signs,indirect signs and characteristic manifestations of respective tumors and being compared with imaging technique of US, ERCP, PTC etc. Restults: CT direct signs of periampullar cancer are soft tissue masses in the area of uncinate process of pancreas, distal common bile duct and papilla duodeni major (91.3%). CT characteristic manifestation of carcinoma of uncinate process of pancreas is enlarging distance between the dilated common bile duct and the dilated pancreatic duct (Double duct sign). CT manifestation of distal common cholangiocarcinoma is non-margin between the mass and the wall of common bile duct. It is difficulty to differentiate between carcinoma of papilla duodeni major and carcinoma in the region of Vater's ampulla.A duodenal filling defect and union of Double duct sign are CT characteristic manifestations of carcinoma of papilla duodeni major and carcinoma in the region of Vater's ampulla. 20 cases (86.9%)were correctly diagnosed preoperatively by CT.Conclusion: It appears that CT is effective and accurate in detecting periampullar cancer.
出处
《中国医学计算机成像杂志》
CSCD
1995年第3期181-184,共4页
Chinese Computed Medical Imaging
