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目的前瞻性评价双相螺旋CT(HCT)术前预测胰腺癌可切除性的诊断价值。方法应用对比剂增强HCT对57例疑似胰腺癌病例进行双相扫描,并对其中28例手术病理证实的胰腺癌病人的术前诊断和分期进行研究。结果28例胰腺癌经外科探查,17例进行根治性切除,7例进行姑息手术。可切除性的阳性预测值为70.8%。7例CT发现可切除的病例,因血管侵犯(5例)、淋巴结转移(2例),术中未能切除。HCT作为判定胰腺癌可切除性的总的精确率为75%(21/28)。结论双相HCT扫描技术是胰腺癌术前分期和可切除性判断的一项有用方法。
Objective To prospectively evaluate the diagnostic value of bi-phase spiral computed tomography (HCT) in predicting the resectability of pancreatic cancer. METHODS: Contrast agent-enhanced HCT was used to perform biphasic scans on 57 cases of suspected pancreatic cancer. Preoperative diagnosis and staging of 28 cases of pancreatic cancer confirmed by pathology were studied. Results Twenty-eight cases of pancreatic cancer were surgically explored, 17 cases underwent radical resection, and 7 cases underwent palliative surgery. The positive predictive value for resectability was 70.8%. In 7 cases of resectable CT, vascular invasion (5 cases) and lymph node metastasis (2 cases) were not performed during the operation. The total accuracy of HCT as a marker for the resection of pancreatic cancer was 75% (21/28). Conclusion Biphasic HCT is a useful method for preoperative staging and resectability judgment of pancreatic cancer.