十二指肠乳头癌的MSCT诊断

目的：探讨MSCT在十二指肠乳头癌诊断中的价值。方法：回顾性分析25例十二指肠乳头癌患者的MSCT及多平面重组（MPR）影像资料,并与手术病理结果对照。结果：25例十二指肠乳头癌MSCT平扫表现为十二指肠乳头区圆形、椭圆形软组织肿块23例,局部肠壁环状增厚2例,多期增强扫描动脉期轻度强化,静脉期强化程度增加,延迟期强化程度减退。胆总管中重度扩张,梗阻端形态呈截断状突然狭窄,肝内胆管轻中度扩张,与肝外胆管扩张程度一致。5例MPR显示十二指肠乳头区软组织肿块突入十二指肠腔内。结论：MSCT不仅能显示十二指肠乳头区肿块及肝内外胆管扩张情况,而且能显示肿块的强化模式,能为十二指肠乳头癌术前诊断提供重要信息。

Multi-slice CT diagnosis of carcinoma of duodenal papilla

Objective：To investigate the value of multi-slice CT （MSCT） in the diagnosis of carcinoma of duodenal papilla.Methods：25 patients with carcinoma of duodenal papilla underwent preoperative contrast-enhanced multi-slice CT.The CT and post-processed multiplanar reconstruction （MPR） manifestations were retrospectively analyzed and correlated with surgical and pathological findings.Results：On plain CT,the manifestations of the carcinoma of duodenal papilla were round or oval masses in the duodenal papilla region （23 cases） and thickening of duodenum wall （2 cases）.On multi-phase contrast enhanced scanning,mild enhancement could be assessed on arterial phase,then increased on venous phase,and reduced on delayed phase.The common bile duct was moderately / seriously dilated.＂Cut off ＂ sign could be seen at the terminal end of obstructed common bile duct,intra-hepatic ducts were dilated moderately and the degree were in consistent with the dilatation of extra-hepatic duct.The duodenal papilla masses were protruded into the duodenal lumen on MPR images in five cases.Conclusion：MSCT not only could show the mass in the duodenal papilla region and the dilatation of intra-/extra-biliary ducts,but also the enhanced mode of the mass,which provided important information in the diagnosis of carcinoma of duodenal papilla before surgery.