MSCT对胰腺癌胰外神经浸润的诊断价值

目的:探讨多排螺旋CT（MSCT）对胰腺癌胰外神经浸润的诊断价值。方法:比较实验组20例胰腺癌患者及对照组50例健康人腹腔神经节的形态、大小及各期CT值变化。以病理结果为标准，分析MSCT对腹腔神经节侵犯的准确性、特异性和敏感性。结果:实验组腹腔神经节形态为粗条形，周围脂肪间隙不清；对照组腹腔神经节形态为细条形或小结节形，周围脂肪间隙清晰。实验组双侧腹腔神经节长径、短径均大于对照组，实验组左侧腹腔神经节3期扫描CT值均大于对照组。与病理结果比较，CT对胰腺癌腹腔神经节侵犯诊断的敏感性、特异性、准确性分别为80%、60%和75%。结论:MSCT对胰外神经浸润具有较高诊断价值，能清晰显示腹腔神经节的形态、大小及CT值变化，当出现腹腔神经节呈粗条形增大、脂肪间隙不清及明显强化时，提示已有肿瘤的神经侵犯。 

Diagnostic Value of MSCT in Extrapancreatic Nerve Infiltration of Pancreatic Cancer

Objective: To investigate the diagnostic value of multi-slice spiral CT (MSCT) in extrapancreatic nerve infiltration of pancreatic cancer. Methods: We compared the morphology, size and CT value of celiac ganglia between 20 patients with pancreatic carcinoma and 50 healthy people. Taking the pathological results as the standard, we analyzed the sensitivity, specificity, accuracy of MSCT in diagnosing the celiac ganglia invasion. Results: In the pancreatic cancer group, the shape of abdominal ganglion was coarse strip, and the fat gap between the tumor and the abdominal ganglion was unclear. The shape of abdominal ganglion in healthy control group was fine strip or small nodular, and the surrounding fat gap was clear. The long diameter and short diameter of bilateral abdominal ganglions in the pancreatic cancer group were higher than those in the healthy group, while the three-phase CT values of left abdominal ganglion in the pancreatic cancer group were higher than those in the healthy group. Compared with the pathological results, the sensitivity, specificity and accuracy of CT in the diagnosis of abdominal ganglion invasion in pancreatic cancer were 80%, 60% and 75%, respectively. Conclusion: MSCT holds high diagnostic value for extrapancreatic nerve infiltration, which can clearly show the morphology, size and CT value of abdominal ganglion. The circumstances of thick-strip enlargement of abdominal ganglion, unclear fat gap and occurrence of obvious enhancement indicate the nerve invasion of the existing tumor.