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目的评价64层螺旋CT重组技术对胰腺导管内乳头状黏液性肿瘤(intraductal papillary mucinous tumors,IPMT)的诊断价值。资料与方法采用64层螺旋CT对10例IPMT患者行平扫和动态增强扫描,将动脉期、胰腺期和肝脏期数据传至工作站,重组成层厚0.5mm、间距0.5mm的高分辨率图像,行曲面重组(CPR)、最小密度投影(MinIP)、最大密度投影(MIP)和容积再现(VR)成像。分析主胰管、胰腺实质和胰腺周围血管的CT征象,并将CT表现与病理对照。结果主胰管扩张7例,胰腺实质内囊性病变8例,主胰管和(或)囊性病变内结节样突起5例,胰腺周围血管未见明确动、静脉受累。CT拟诊主胰管型IPMT2例,分支胰管型IPMT5例,混合型IPMT3例,与病理结果一致。结论多层螺旋CT重组技术对IPMT的诊断、分型具有重要的应用价值。
Objective To evaluate the diagnostic value of 64-slice spiral CT in the diagnosis of intraductal papillary mucinous tumors (IPMT). Materials and Methods 10 cases of IPMT underwent plain scan and dynamic contrast-enhanced scanning with 64-slice spiral CT. The arterial phase, pancreatic phase and hepatic phase were transmitted to the workstation and reconstructed into high resolution images with 0.5mm layer thickness and 0.5mm pitch (CPR), MinIP, MIP, and VR imaging. Analysis of the main pancreatic duct, pancreatic parenchyma and pancreas around the CT signs and CT findings and pathological control. Results The main pancreatic duct dilated in 7 cases, pancreatic parenchymal cystic lesions in 8 cases, the main pancreatic duct and (or) cystic lesions nodular processes in 5 cases, no clear peripheral vascular pancreas and vein involvement. CT was diagnosed with pancreatic duct type IPMT2 cases, branching pancreatic duct type IPMT5 cases, mixed type IPMT3 cases, consistent with the pathological findings. Conclusion Multi-slice spiral CT reconstruction has important value in the diagnosis and classification of IPMT.