摘要
目的探讨螺旋CT扫描对胰胆管十二指肠区癌的诊断及鉴别诊断的价值,进一步提高螺旋CT诊断的敏感性与准确性。方法连接区癌18例,包括胰头癌10例(其中6例位于胰钩突),胆总管下端癌4例,vater氏壶腹癌4例;另外3例胰头区炎症,作为对照。所有病例均经病检证实。结果连接区癌表现为胰头或钩突增大变形、密度不均,胆总管壁不规则增厚或下端软组织结节,十二指肠内侧壁结节;胰头癌、vater氏壶腹癌、胆总管下端癌的密度变化与肿瘤的病理相关;大部分病例有胰胆管扩张,胰胆管是否扩张与肿瘤的大小及生长位置有关。胰头区炎症亦表现为胰头增大、胰胆管扩张,但增大的胰头密度均匀,明显均匀强化,周围结构模糊,胰体多肿大,胆管积气,此点可与肿瘤鉴别。结论螺旋CT对胰胆管十二指肠连接区癌的诊断具有较高的准确性,特别是对连接区早期癌的诊断与鉴别诊断具有很高的价值。
Objective To explore the value of spiral CT in the diagnosis of pancreaticobiliary carcinoma at the choledochoduodeual junction, in order to improve the diagnostic sensitiv- ity and accuracy of spiral CT. Methods 8 cases of the carcinoma at the junction area, including l0 cases of pancreatic head cancer（ including 6 cases located in the pancreatic uncinate process）, 4 cases of the distal common bile duct carcinoma, 4 cases of Vater＇s ampullary carcinoma： 3 cases of pancreatic head inflammation as normal control. All cases were confirmed by pathological examination confirmed. Results （1） connecting zone carci- noma presented as pancreatic head and uncinate process increases or deformation, uneven density, irregular thickening of the common bile duct or soft tissue nodules at the bottom, internal wall nodule of the duodenal. The density of the carcinoma of head of pancreas, Vater＇s arnpullary carcinoma and bile duct cancer changes due to the different pathological types. Most of the cases shown dilated pancreatic duct and biliary duct, and the dilatation of the pancreatic duct and biliary duct related to the tumor size and location. （2） the head of pancreas inflammation presented as pancreatic head enlargement too, dialatated pancreatic duct, and uniform density of the enlarged pancreatic head, homogeneously enhancement, the peripheral structure was fuzzy, and the pancreatic body usually enlarged, anti the bile duct pneumalosis, which can be distinguished from tumors. Conclusion spiral CT was accuracy in diagnosing the pancreaticobiliary carcinoma at the choledochoduodenal junction, especially for early stage carcoma.
出处
《中国CT和MRI杂志》
2013年第2期41-43,118,共4页
Chinese Journal of CT and MRI
关键词
胆胰管十二指肠连接区
胰
腺癌
炎症
鉴别诊断体层摄影
X线计算机
junction area of choledochopancreatic duct and duodenum pancreas inflammation
cancer diagnosis tomography
X ray computed
