CAJ | 학술논문

目的：探讨双源 CT 对胰头癌胰周良恶性淋巴结的鉴别价值。方法分析手术病理证实的119例胰头癌患者的双源 CT平扫及增强资料,记录淋巴结的部位、数目,测量其短、长径并计算短长径比,比较其强化方式及 CT 值变化。计量资料组间均数比较采用 t 检验,计数资料采用χ2检验。结果119例胰头癌患者胰周淋巴结转移率为68.1%(81/119)。切除标本中共检出334枚淋巴结,其中239枚为转移,占71.6%,反应性增生95枚,占28.4%。增强后淋巴结环状强化、均匀强化的转移率分别为99.1%(111/112)、57.7%(128/222),转移淋巴结、反应性增生淋巴结 CT 值增加分别为(23.8±3.2)HU、(14.3±2.3)HU,以及良恶性淋巴结的平均短径、长径、短长径比,组间比较,差异均有统计学意义(P <0.05)。结论双源 CT 能清晰显示胰头癌胰周淋巴结,当淋巴结短径≥8 mm、长径≥12 mm、短长径比≥0.75时,增强后淋巴结环状强化、强化前后 CT 值增加≥25 HU 时,强烈提示淋巴结转移。
목적：탐토쌍원 CT 대이두암이주량악성림파결적감별개치。방법분석수술병리증실적119례이두암환자적쌍원 CT평소급증강자료,기록림파결적부위、수목,측량기단、장경병계산단장경비,비교기강화방식급 CT 치변화。계량자료조간균수비교채용 t 검험,계수자료채용χ2검험。결과119례이두암환자이주림파결전이솔위68.1%(81/119)。절제표본중공검출334매림파결,기중239매위전이,점71.6%,반응성증생95매,점28.4%。증강후림파결배상강화、균균강화적전이솔분별위99.1%(111/112)、57.7%(128/222),전이림파결、반응성증생림파결 CT 치증가분별위(23.8±3.2)HU、(14.3±2.3)HU,이급량악성림파결적평균단경、장경、단장경비,조간비교,차이균유통계학의의(P <0.05)。결론쌍원 CT 능청석현시이두암이주림파결,당림파결단경≥8 mm、장경≥12 mm、단장경비≥0.75시,증강후림파결배상강화、강화전후 CT 치증가≥25 HU 시,강렬제시림파결전이。
Objective To investigate differential diagnostic value of dual-source computed tomography (DSCT)for the benign or malignant lymph node of pancreatic head cancer.Methods The plain and contrast DSCT data of 1 1 9 patients with pancreatic head cancer proved by operation and pathology were analyzed retrospectively.The distributions,number,short and long axis diameters and ratio of short-to long-axis diameter,enhancement modality and enhancement degree of lymph nodes were recorded.A1l data were analyzed using the t test or chi-square test.Results The positive rate of lymph node metastasis was 68.1% (81/1 1 9).Lymph node metastases were found in 239 out of 334 lymph nodes,and reactive hyperplasia were found in 95 lymph nodes (28.4%,95/334).The positive rate of lymphatic metastasis with rim-1ike enhancement was 99.1% (1 1 1/1 12),which was significantly higher than 57.7% (128/222)of lymphatic metastasis with homogeneous enhancement.The increased CT value of metastatic lymph nodes was (23.8±3.2)HU,which was significantly higher than (14.3±2.3)HU of patients with reactive hyperplasia lymph nodes.The short-and long-axis diameters and the ratio of short-to long-axis diameter showed significant difference between benign or malignant lymph nodes (P <0.05 ).Conclusion DSCT could detect lymph node metastasis of the cancer of the pancreatic head.When the short axis diameter of the lymph nodes ≥8 mm,long axis diameter of the lymph nodes ≥12 mm,the ratio of short-to long-axis di-ameter ≥0.75,and the rim-1ike enhancement and increased value after enhancement ≥25 HU,high sensitivity of dual-source CT for the diagnosis of lymph node metastasis of cancer of the head of pancreas could be achieved.