双源 CT 双能量成像技术动态增强在胰腺癌诊断中的价值

摘要

Objective To investigate the value of dynamic dual energy CT imaging enhancement in the diagnosis and preoperative assessment of pancreatic cancer. Methods Forty cases with pancreatic cancer confirmed by surgery were selected, 20 cases were detected by dualsource CT dualenergy scanning, and 20 cases were detected by conventional scanning enhancement. Retrospective analysis of CT signs of pancreatic cancer, according to the tumor lesions character-istics, local invasion, vascular invasion and metastasis for the resectability assessment, and two scanning methods for the comparative assessment. Results The diagnostic accuracy rate of the dual source CT dual energy scanning was 90. 0%(18/20), the conventional scanning was 75. 0% (15/20). The tumor detection rate of the conventional scanning was 86. 6% (13/15), dual source CT dual energy scanning was 88. 8% (16/18). Detection rates of dual source CT dual energy scanning and conventional CT scanning of peri-pancreatic violation and peri-pancreatic vascular involvement were 85. 7% (12/14), 80. 0% (12/15) and 83. 3% (10/12), 69. 2% (9/13), respectively. The dual source CT dual energy scanning resectability of 8 cases, the actual surgery resection was 7 cases;10 cases of unresectable, actual unre-sectable was 9 cases; the sensitivity, specificity and accuracy to determine resectability of pancreatic cancer were 87. 5%, 90. 0% and 90. 0%. Compared with conventional scanning, dual-energy scanning technology combined with a virtual unenhanced had lower radiation dosage. Conclusion Dual source CT dual energy scanning has an accurate as-sessment for pancreatic cancer, it has some practical value for clinical diagnosis and treatment, it also greatly reduce the radiation dosage.%目的：探讨双源CT双能量成像技术动态增强在胰腺癌的诊断及术前可切除性评估中的价值。方法收集40例经手术证实的胰腺癌患者，术前2周行双源CT双能量及常规增强扫描各20例，回顾性分析胰腺癌CT征象，根据肿瘤病灶特征、局部侵犯、血管受累和转移情况进行可切除性评估，并对比评估两种扫描方法。结果双源CT双能量及常规动态成像诊断准确率分别为90.0%(18/20)、75.0%(15/20)；肿块检出率分别为88.8%(16/18)、86.6%(13/15)；胰周侵犯、胰周血管受累评价准确率分别为85.7%(12/14)、80.0%(12/15)及83.3%(10/12)、69.2%(9/13)。双源CT双能量动态增强评估手术可切除8例，实际切除7例；10例认为不可切除，实际不可切除9例；判断胰腺癌可切除的敏感性、特异性及准确性分别为87.5%、90.0%及90.0%。采用虚拟平扫，辐射剂量较常规扫描辐射剂量明显下降。结论双源CT双能量扫描能够准确评价胰腺癌且大大减少辐射剂量，对于临床诊断治疗具有一定的实用价值。