多层螺旋CT血管造影对胰腺癌的术前评估.pdfVIP

· 4670· 实用医技杂志2007年l2月第l4卷第34期(旬刊) JPMT，December．2007，Vo1．14，No．34(Issued EveryTenD 多层螺旋CT血管造影对胰腺癌的术前评估 张 练，张卫东，徐 辉，吴 刚 (南京医科大学附属南京第一医院，江苏南京210006) [摘 要]目的：探讨多层螺旋cT血管造影(MSCTA)对胰腺癌手术可切除性的评估价值。方法：收集l9例经手 术及病理证实的胰腺癌，术前进行多层螺旋CT检查，结合容积重建(VR)、多平面重建(MPR)、最大密度投影(MIP) 及曲面成像ecPR)等重建技术，对胰腺癌术前进行评估。结果：术前综合评估不能切除的5例中手术均无法切除，术 前评估能切除的14例中，手术结果能切除12例，评估可切除率达86％。结论：MSCTA造影对胰腺癌的术前可切除性 评估具有很高的一临床参考价值。 [关键词]胰腺癌；多层螺旋CT；评估；血管造影 [中图分类号]R735．9 [文献标识码]A [文章编号]1671-5098(2007)34-4670-02 The Pre。perative Assessment in Pancreatic Carcinoma by MlIlti。slice CT ZHANG Lian，ZHANG Wei—dong，XU Hui，WU Gang (The Affiliated Nanjing First Hospital ofNanjing Medical Unh~ers ，Nanjing，Jiangsu 210006，China) Abstract：Objective To evaluate appearances and diagnostic value of multi—slice CT on pre—operation assessment in pan— creatic carcinoma．Methods 19 cases of pancreatic carcinoma proved by surgically and patholoically were collected，multi—slice CT manifestation were retrospectively analyzed．Combining the VR，MPR，CPR，MIP images and transaxial images to assess whether the cases were respectable．Results All 19 patients were operated，5 cases which were assessed unresentable by MSCT，all were actually unresected in operation．In 14 cases assessed by MSCT，12 all were actually unresected in operation， the rate of unresection was 86％．Conclusion Multi—slice CT is valuable in the respectability assessment before operation． Key words：Pancreatic carcinoma；Multi—slice spiral CT；Assessment；angiography 近年来，胰腺癌的发病率在不断上升，手术切除仍然是一 VR、MIP、MPR及CPR重建图像能很好显示胰腺癌血管 种可靠的治疗手段。但不少病例在发现时已失去手术指征， 受侵情况，VR和MIP图像显示血管全貌较好，尤其是显示动 形成远处转移或血管广泛浸润，因此术前进行正确的评估显 脉血管好于静脉血管。而MPR能较精细显示胰腺癌与局部 得尤其重要。随着螺旋CT技术的不断进展，特别是螺旋CT 血管的关系，CPR却能更精确测量血管受侵的长度。 三维血管重建技术的完善，在胰腺癌周围血管的受侵方面显 3 讨论 示出独特价值，很大程度