16层螺旋CT重建技术对导管内乳头状黏液性肿瘤的诊断价值.pdfVIP

· 800· 主 塑 苤查 !笙 旦箜 鲞箜12期 Chin J Hepatobiliary Surg，December 2007，Vo1．13，No．12 · 论著 · 1 6层螺旋CT重建技术对导管内乳头状 黏液性肿瘤的诊断价值 叶彤 曾蒙苏 史讯 傅爱燕 靳大勇 纪元 【摘要】 目的 评价 16层螺旋CT重建技术对导管内乳头状黏液性肿瘤(intraductal papillary mucmous tumors， IPMT)的诊断价值。方法 采用 1 6层螺旋 CT对14例IPMT行平扫和动态增强 扫描，将动脉期和胰腺期数据传至工作站，重建成厚度为0．75 mm、间距为0．5 mm的高分辨率图像， 作曲面重建(curve planar reformation，CPR)和最大密度投影(maximum intensity projection，MIP)。 分析主胰管、胰腺实质、十二指肠乳头和胰腺周围血管的CT征象，并将 CT的分型和恶变预测的结 果与病理对照。结果 CT表现为主胰管扩张9例，胰腺实质内囊性病变 11例，主胰管和囊性病变内 见分隔和(或)结节样突起，十二指肠乳头增大 6例，肿瘤侵犯胰腺周围血管1例。CT诊断主胰管型 IPMT 3例，分支胰管型IPMT 5例，混合型IPMT 6例，IPMT恶变6例。病理学分型与CT分型～ 致，镜下诊断导管内乳头状黏液腺癌7例。结论 多层螺旋CT重建技术对IPMT的诊断、分型和恶 变预测具有重要的临床应用价值。 【关键词】 胰腺肿瘤； 计算机断层成像； 诊断 Diagnostic value of 16。slice computed tomography reformation technology for intraductal papillary mucin- ous tumor yE Tong，ZENG Meng—su，SHI Xun，et a1．Department of Radiology，Zhongshan Hos— pital，Fudan University，Shanghai 200032，P．R．China [Abstract] Objective To explore the value of 1 6-slice computed tomography reformation teeh nology in diagnosing intraductal papillary mueinous tumor(IPMT)．Methods Fourteen cases of IPMT were examined bv 1 6-slice CT including plain scanning and dynamic contrast—enhanced scan— ning．The arteria1 and pancreatic enhancement data were transferred to the workstation and reeon— structed to the high—resolution image with a slice thickness of 0．75 mm and inter-sliee gap of 0．5 mm． Curve planar reformation of the pancreas and maximum intensity proj eetion of the abdomina1 vessels were then performed．The CT features of pancreatic main duct，the pancreatic parenehyma，the papilla of Vater and the vessels around the pancreas were analyzed．The CT classification and malignant pre diction of IPMT were compared with pathologic results．Results Pancreatic main duct dilation was seen in 9 cases and cystic 1esions within the pancreatic parenehyma