影像学检查在壶腹周围癌诊断中的应用价值

摘要

目的 探讨各种影像学检查在壶腹周围癌诊断中的应用价值.方法 对本院2004年1至2009年1月的5年间收治的76例经病理检查证实的壶腹周围癌患者的临床影像学检查资料进行回顾性分析.结果 胰头癌中BUS或CT的诊断阳性率高于ERCP(P=0.044,P=0.029).十二指肠乳头癌中ERCP的诊断阳性率高于BUS和CT(P=0.005,P=0.03).壶腹癌中ERCP的诊断阳性率高于BUS和CT(P=0.157,P=0.282).MRCP在壶腹癌和十二指肠乳头癌中阳性率分别为100%、88.9%.结论 BUS+CT检查是诊断胰头癌的最佳方法.ERCP是诊断壶腹癌和十二指肠乳头癌的最佳方法.而MRCP检查应用前景十分广阔.%Objective To discuss the value of imaging examination in the diagnosis of periampullary carcinoma.Methods A retrospective analysis of 76 patients with pathologically periampullary carcinomas enrolled in Zhongshan Hospital between Jan.2004 and Jan.2009.Results The accuracy of BUS or CT was higher than that of ERCP in patients with pancreatic head carcinoma (P = 0.044,P = 0.029,respectively).The accuracy of ERCP was higher than that of BUS or CT in patients of juxtapapillary duodenal carcinoma (P =0.005 ,P =0.03 ,respectively).The accuracy of ERCP is higher than that of BUS or CT in patients of ampullary carcinoma (P = 0.157,P = 0.282,respectively).The accurary of MRCP was 100% ,88.9%,respectively.Conclusion BUS + CT is the manner of choice in the diagnosis of pancreatic head carcinoma,ERCP was suitable for nonpancreatic periampullary cancer.MRCP should be applied widely in the future.