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目的探讨螺旋CT双期薄层增强扫描在胰岛素瘤诊断中的价值。资料与方法经手术病理证实的胰岛素瘤患者16例,术前行胰腺螺旋CT双期薄层增强扫描。扫描延迟时间动脉期21～26s,门静脉期65～70s。注射非离子型对比剂80～100ml,注射流率2.5～3.0ml/s。采用单层螺旋CT扫描10例,16层螺旋CT扫描6例。扫描层厚2.5～3.0mm。结果16例中,检出12例动脉期均为高密度,门静脉期10例为等密度,2例为高密度,瘤体直径0.8～2.5cm;4例平扫及增强均未发现明显肿瘤。16例中肿瘤单发14例,多发2例。结论螺旋CT动脉期增强薄层扫描能更清晰地显示胰岛素瘤,结合门静脉期对提高胰岛素瘤的检出率和诊断符合率有较高的临床应用价值。
Objective To investigate the value of dual-phase spiral CT in the diagnosis of insulinoma. Materials and Methods 16 cases of insulinoma confirmed by surgery and pathology were performed double-phase thin-slice enhanced-scan of pancreas spiral CT before operation. Delayed scan time arterial 21 ~ 26s, portal vein 65 ~ 70s. Injection of non-ionic contrast agent 80 ~ 100ml, injection rate 2.5 ~ 3.0ml / s. Using single-slice spiral CT scan in 10 cases, 16-slice spiral CT scan in 6 cases. Scanning layer thickness 2.5 ~ 3.0mm. Results Of the 16 cases, 12 cases were detected with high density in arterial phase, 10 cases in portal vein with isodense density, 2 cases with high density and 0.8 ~ 2.5 cm in diameter. No obvious tumor was found in 4 cases. Of the 16 cases, 14 were single and 2 were multiple. Conclusion The spiral CT enhanced arterial phase thin-section scan can clearly show the insulinoma, combined with the portal venous phase to improve the detection rate of insulinoma and diagnostic accuracy of a higher clinical value.