胰腺癌多层螺旋CT诊断的研究进展.pdfVIP

《中国癌症杂志》2005 年第15 卷第4 期 CHINA ONCOLOGY 2005 Vol. 15 No. 4 395 胰腺癌多层螺旋CT 诊断的研究进展 任刚 综述 陈克敏 审校 上海第二医科大学附属瑞金医院放射科，上海200025 ［摘要］ 胰腺癌是最常见的原发性胰腺恶性肿瘤。症状没有特异性，一般包括腹痛、黄疸、没有食欲、体重减 轻、恶心和呕吐。胰腺癌在CT 上多表现为边界不清的含实质成分的肿块并伴有胰管的扩张；肿瘤通常较小，没有 钙化；在注射造影剂后，肿块显像的强化程度低于周围正常胰腺实质；肿块为卵圆形、圆形或表现为分叶状，多有局 部浸润。这些特点有助于胰腺癌和其他胰腺肿瘤的鉴别诊断。 ［关键词］ 胰腺癌； 螺旋CT ； 诊断 中图分类号： R736. 7 文献标识码：A 文章编号：1007-3639（2005 ）04-0395-04 Advance in reseach on the diagnosis for pancreatic carcinoma by spiral CT REN Gang, CHEN Ke- ming ( Dep artment of Radiology, Ruij ing Hosp ital, Shanghai Second Medical University, Shanghai 200025, China) [ Abstract] Carcinoma of pancreas is the most common primary pancreatic malignancy. Symptoms usually are non- specific and include abdominal pain, jaundice, loss of appetite, weight loss, nausea, and vomiting. CT usually demon- strates a mass with ill-defined margins but also solid components and dilatation of the main pancreatic duct. This tumor is usually smaller and virtually never contains calcification. Following contrast material administration, all masses were en- hanced less than the surrounding pancreas. Tumors were oval, round or lobular, and is almost always locally invasive. These features can be used to differentiate carcinoma of pancreas from other pancreatic tumors. [ Key words] carcinoma of pancreas; helical CT; diagnosis 近年来，胰腺癌的发病率有上升的趋势，手术仍 膜上动脉（SMA ）和腹腔动脉（CA ）常常是从背侧区 是目前最主要的治疗手段。由于发现病变较迟，确 分胰头和胰体部的最重要标志，其右侧为胰头，向后 诊后仅有10% 左右的患者能手术切除，5 年生存率 下绕至肠系膜上静脉（SMV ）的后方形成钩突；左侧 较低，因此早期发现小肿瘤尤为重要。胰腺癌的好 为胰体，在左肾上腺和肾脏前方伸向脾门，其延伸在 发年龄是60 ～ 70 岁，男性略多于女性。其临床症状 脾肾韧带内的部分为胰尾。脾静脉（SV