胰十二指肠切除术后壶腹周围癌患者肠系膜淋巴结肿大的意义：多层螺旋CT系列研究评估

Significance of mesenteric lymphadenopathy after pancreaticoduodenectomy for periampullary carcinomas: evaluation with serial MDCT studies.

作者信息

Ishigami Kousei, Yoshimitsu Kengo, Irie Hiroyuki, Tajima Tsuyoshi, Asayama Yoshiki, Hirakawa Masakazu, Kakihara Daisuke, Shioyama Yoshiyuki, Nishihara Yunosuke, Yamaguchi Koji, Honda Hiroshi

机构信息

Department of Clinical Radiology, Anatomic Pathology, and Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.

出版信息

Eur J Radiol. 2007 Mar;61(3):491-8. doi: 10.1016/j.ejrad.2006.10.008. Epub 2006 Nov 16.

DOI:10.1016/j.ejrad.2006.10.008

PMID:17112696

Abstract

OBJECTIVE

To evaluate the significance of mesenteric lymphadenopathy arising after pancreaticoduodenectomy (PD) for periampullary carcinomas.

MATERIALS AND METHODS

Serial multidetector CT (MDCT) studies in 44 patients after PD for periampullary carcinomas (Group A) were retrospectively reviewed, the incidence and interval changes of mesenteric lymphadenopathy were evaluated, and comparisons were made with 21 patients who underwent PD for benign diseases (Group B).

RESULTS

In Group A, mesenteric lymphadenopathy was seen in 31 of 44 (70.5%) patients. The short axis diameter of the largest lymph node ranged from 6.2 to 11.5mm (mean+/-S.D.: 8.6+/-1.4mm), and the short-axis-to-long-axis (S/L) ratio ranged from 0.46 to 0.99 (mean+/-S.D.: 0.69+/-0.12). Six of the 31 (19.4%) mesenteric lymphadenopathy cases showed interval increases in size on follow-up studies, and three cases showed new development of mesenteric lymphadenopathy: all of these nine cases had concurrent recurrence in the mesenteric root. In Group B, 11 (52.4%) had mesenteric lymphadenopathy. The short axis diameter of the largest lymph node ranged from 5.6 to 10.9mm (mean+/-S.D.: 8.0+/-1.9mm) and the S/L ratio ranged from 0.48 to 0.93 (mean+/-S.D.: 0.67+/-0.12). Differences in the incidence, short axis diameter and S/L ratio were not significant between Groups A and B (p=0.154, 0.271 and 0.654, respectively).

CONCLUSION

Mesenetric lymphadenopathy after PD less likely reflects recurrence. Lymph node metastasis may be suggested only when coexisting recurrent mass is found in the proximal mesenteric root.

摘要

目的

评估胰十二指肠切除术（PD）后壶腹周围癌患者发生肠系膜淋巴结肿大的意义。

材料与方法

回顾性分析44例行PD治疗壶腹周围癌患者（A组）的系列多层螺旋CT（MDCT）检查结果，评估肠系膜淋巴结肿大的发生率及间隔期变化，并与21例行PD治疗良性疾病患者（B组）进行比较。

结果

A组44例患者中，31例（70.5%）出现肠系膜淋巴结肿大。最大淋巴结短轴直径为6.2至11.5mm（均值±标准差：8.6±1.4mm），短轴与长轴（S/L）比值为0.46至0.99（均值±标准差：0.69±0.12）。31例肠系膜淋巴结肿大病例中，6例（19.4%）在随访研究中显示淋巴结大小有间隔期增大，3例出现新的肠系膜淋巴结肿大：这9例均在肠系膜根部同时存在复发。B组中，11例（52.4%）有肠系膜淋巴结肿大。最大淋巴结短轴直径为5.6至10.9mm（均值±标准差：8.0±1.9mm），S/L比值为0.48至0.93（均值±标准差：0.67±0.12）。A组和B组在发生率、短轴直径及S/L比值方面差异无统计学意义（p分别为0.154、0.271和0.654）。