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慢性胰腺炎的评估:256层计算机断层扫描全胰腺灌注成像的应用

Assessment of Chronic Pancreatitis: Use of Whole Pancreas Perfusion With 256-Slice Computed Tomography.

作者信息

Arikawa Shunji, Uchida Masafumi, Kunou Yukiko, Kaida Hayato, Uozumi Jun, Hayabuchi Naofumi, Okabe Yoshinobu, Murotani Kenta

机构信息

From the *Department of Radiology and †Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan; and ‡Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.

出版信息

Pancreas. 2012 May;41(4):535-540. doi: 10.1097/MPA.0b013e3182374fe0. Epub 2012 Jan 5.

Abstract

OBJECTIVE

We aimed to compare perfusion computed tomography (CTP) characteristics of the normal pancreas with those of chronic pancreatitis (CP) and to examine the possibility of evaluating pancreatic exocrine function with CTP. METHODS: Thirty-two patients (control group, n = 18; CP group, n = 14) who completed the whole pancreas CT perfusion examination with 256-slice CT were studied. Four parameters, including perfusion (PF), peak enhancement intensity (PEI), time-to-peak (TTP), and blood volume (BV), were measured and compared between the control and CP groups, and between patients with and without exocrine pancreatic insufficiency (EPI) in the CP group. Pancreatic exocrine function was determined via serum trypsinogen. RESULTS: There was no significant difference between the distribution of PF, PEI, and BV in different pancreas regions, namely, the head, body, and tail (P > 0.05). PF, PEI, and BV of the CP group were significantly decreased, and TTP was significantly increased compared with the control group (P < 0.05). A significant decrease of PF, PEI, and BV and increase of TTP were observed in patients with EPI than in patients without EPI (P < 0.05). CONCLUSIONS: Perfusion CT is an appropriate imaging technique to diagnose CP and may be useful as a screening test to rule out early EPI.

摘要

目的

我们旨在比较正常胰腺与慢性胰腺炎(CP)的灌注计算机断层扫描(CTP)特征,并探讨用CTP评估胰腺外分泌功能的可能性。方法:研究了32例完成256层CT全胰腺CT灌注检查的患者(对照组,n = 18;CP组,n = 14)。测量并比较了对照组和CP组之间,以及CP组中有和没有胰腺外分泌功能不全(EPI)的患者之间的四个参数,包括灌注(PF)、峰值强化强度(PEI)、达峰时间(TTP)和血容量(BV)。通过血清胰蛋白酶原测定胰腺外分泌功能。结果:PF、PEI和BV在胰腺不同区域(即头部、体部和尾部)的分布之间无显著差异(P > 0.05)。与对照组相比,CP组的PF、PEI和BV显著降低,TTP显著增加(P < 0.05)。与没有EPI的患者相比,有EPI的患者观察到PF、PEI和BV显著降低,TTP增加(P < 0.05)。结论:灌注CT是诊断CP的一种合适的成像技术,可能作为排除早期EPI的筛查试验有用。

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