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目的探讨胰腺癌的CT不典型征象特点与漏误诊原因,提高对本病的诊断准确率。方法回顾性分析2008年1月至2014年4月39例胰腺癌CT影像特点、解析漏诊误诊原因。结果 2008年1月至2014年4月经CT扫描并经手术、穿刺活检病理检查证实和临床随访证实的39例胰腺癌中,22例位于胰头及(或)钩突部,胰颈部10例,体尾部7例。CT平扫及增强扫描准确诊断胰腺癌28例,漏误诊11例。漏误诊11例中,1例钩突部、1例体部外生肿块CT平扫及增强无明显密度差而漏诊;慢性胰腺炎并发胰腺癌误诊2例;2例胰头癌误诊为胰腺导管内乳头状黏液性肿瘤;1例胰腺黏液腺癌误诊为囊腺瘤;1例胰头及另1例胰尾较大肿块,误诊为囊腺癌;误诊为壶腹癌1例;误诊为胰腺转移性肿瘤1例。结论胰腺癌的CT准确诊断依赖于检查技术的合理应用及充分认识胰腺癌的不典型CT表现。
Objective To investigate the characteristics of atypical CT features of pancreatic cancer and the causes of misdiagnosis, and to improve the diagnostic accuracy of this disease. Methods A retrospective analysis of 39 cases of pancreatic cancer from January 2008 to April 2014 CT features, misdiagnosis of misdiagnosis causes. Results From January 2008 to April 2014, of the 39 pancreatic cancers confirmed by CT scan, confirmed by biopsy and clinical follow-up, 22 were located in the pancreas and / or the uncinate process and the pancreas in 10 cases , Body and tail in 7 cases. CT scan and enhanced scan accurate diagnosis of pancreatic cancer in 28 cases, misdiagnosis in 11 cases. Misdiagnosis and misdiagnosis of 11 cases, 1 case of uncinate process, 1 case of external body mass CT scan and enhanced without significant density difference and missed diagnosis; chronic pancreatitis complicated with pancreatic cancer misdiagnosed in 2 cases; 2 cases of pancreatic cancer misdiagnosed as pancreatic duct 1 case of pancreatic mucinous adenocarcinoma misdiagnosed as cystadenoma; 1 case of pancreatic head and the other 1 case of pancreatic tail larger tumor misdiagnosed as cystadenocarcinoma; misdiagnosed as ampullary carcinoma in 1 case; misdiagnosed as the pancreas Metastatic tumor in 1 case. Conclusion The accurate diagnosis of CT in pancreatic cancer depends on the reasonable application of examination techniques and fully understanding the atypical CT findings of pancreatic cancer.