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目的 分析胰腺癌CT误诊和漏诊原因 ,提高对胰腺癌CT诊断和鉴别诊断能力。方法 对 17例术前误诊的胰腺癌病例进行回顾性分析。CT检查采用螺旋CT动脉期和静脉期扫描 ,层厚 3～ 5mm。结果 17例胰腺癌中 ,术前CT误诊为慢性胰腺炎 4例 ,慢性胰腺炎伴假性囊肿 2例 ,胰腺假性囊肿 1例 ,壶腹部癌 2例 ,十二指肠恶性肿瘤 2例 ,胃癌 2例 ,CT未见明确肿块而漏诊 4例。术后诊断胰头癌 15例 ,胰体部癌 1例 ,胰尾部癌 1例。病理诊断胰腺腺癌 15例 ,胰腺癌伴慢性胰腺炎 1例 ,导管内乳头状癌 1例。结论 注意螺旋CT扫描方法 ,仔细阅片 ,全面分析 ,能减少CT对胰腺癌的误诊率和漏诊率
Objective To analyze the causes of misdiagnosis and misdiagnosis of CT in pancreatic cancer and to improve the ability of CT diagnosis and differential diagnosis of pancreatic cancer. Methods 17 cases of pancreatic cancer misdiagnosed before surgery were retrospectively analyzed. CT examination using spiral CT arterial phase and venous phase scanning, layer thickness 3 ~ 5mm. Results 17 cases of pancreatic cancer, preoperative CT misdiagnosed as chronic pancreatitis in 4 cases, 2 cases of chronic pancreatitis with pseudocysts, pancreatic pseudocyst in 1 case, ampullary carcinoma in 2 cases, duodenal malignancies in 2 cases, Gastric cancer in 2 cases, CT no clear mass and missed diagnosis in 4 cases. Postoperative diagnosis of pancreatic cancer in 15 cases, 1 case of pancreatic cancer, pancreatic cancer in 1 case. Pathological diagnosis of pancreatic adenocarcinoma in 15 cases, pancreatic cancer with chronic pancreatitis in 1 case, ductal papillary carcinoma in 1 case. Conclusion pay attention to spiral CT scan method, carefully read the film, a comprehensive analysis can reduce the misdiagnosis rate and misdiagnosis rate of pancreatic cancer by CT