摘要
目的分析小胰腺癌CT误诊或漏诊的原因。方法回顾性分析17例初次CT误诊或漏诊、后经病理或随访证实小胰腺癌病例,男性10例,女性7例,平均年龄63岁。分别对病变的大小、形态、密度及强化方式进行回顾性分析,同时评估胰管和胆管扩张、胰腺萎缩和转移的情况。结果17例病变中胰头10例、胰体4例、胰尾3例。病变的平均直径为1.8cm(1.2～2cm)。平扫14例表现为等密度,3例为低密度;动脉期11例为低密度,6例为等密度;门脉期8例为低密度,9例为等密度。5例显示胆管扩张,6例胰管扩张。5例出现肝脏转移。结论单层螺旋CT对早期小胰腺癌的诊断有一定的难度,漏诊和误诊的原因主要包括病变较小,对比较差,扫描层厚太厚,扫描时机欠妥当,对病变的主观认识不足等。优化扫描技术,提高认识是提高诊断水平的关键。
Objective To analysis the reasons of CT missed and misdiagnosis in small pancreatic adenocarcinoma. Methods Seventeen cases （7 women and 10 men; mean age, 63 years） with pancreatic adenocarcinoma were missed or misdiagnosed at the first CT examination. The following data for each tumor were evaluated including size, location, margination, internal density, and contrast enhancement pattern. In addition, The presence of pancreatic or bile duct dilation, atraphy of pancreas, and metastases was assessed. Results Masses were distributed throughout the pancreas （head, n=10; body, n=4; and tail, n=3）. The mean longer dimension were 1.8 cm （range from 1.2 to 2.0 cm）.Thirteen masses enhanced homogeneously. Twelve lesions were isodensity and three were hypo-density before contrast. In arterial phase eleven lesions were hypo-density and four iso-density. In venous phase eight were hypo-density and seven iso-density. Common bile and pancreatic duct dilatation were present in four and five patients, respectively. Five patients had metastatic liver disease at presentation. Conclusion It is a challenge to show the small pancreatic cancer with CT. The optimized scan technique is the key of diagnosis. The main reasons of missed or misdiagnosed are less size, larger scan thickness, improper scan opportunity and deficient cognition.
出处
《上海医学影像》
2007年第2期99-101,共3页
Shanghai Medical Imaging
关键词
胰腺癌
体层摄影术
X线计算机
Pancreatic adenocarcinoma
Tomography, X-ray computed
