Karasawa E, Goldberg H I, Moss A A, Federle M P, London S S
Radiology. 1983 Aug;148(2):489-93. doi: 10.1148/radiology.148.2.6867347.
CT has made it possible to determine the contour of the pancreatic duct, to measure its caliber, and to detect dilatation of the duct. CT scans of 75 patients with pancreatic carcinoma and of 45 patients with chronic pancreatitis were obtained. Dilatation of the pancreatic duct was seen in 56% of patients with carcinoma, and in 70% of those with tumors confined to the pancreatic head and body. Smooth dilatation (43%) or beaded dilatation (40%) were most commonly associated with carcinoma. Ductal dilatation was present in 58% of the patients with chronic pancreatitis, and irregular dilatation was seen in 73% of the patients in this group. About half of the patients who had irregular dilatation had calculi within the ducts. The duct contour was similar to that seen in carcinoma in 27% of the cases of chronic pancreatitis. There was a significant difference in the caliber of the duct (P = .01) with larger ducts seen in patients with carcinoma. The width of the pancreatic gland (P = .005) and the ratio of duct caliber to gland width differed (P = .001) between the two diseases: the gland was wider in cases of chronic pancreatitis, and the ratio of duct to gland was larger in cases of carcinoma. Eight cases of dilatation of the duct with no detectible pancreatic mass were seen in a subgroup of 13 patients who had small carcinomas of the pancreas (tumor size of 3 cm or less). Our findings indicate that a dilated pancreatic duct with a smooth contour and a ratio of duct to total gland width of 0.50 or greater suggests carcinoma as the underlying pathology.
CT已使确定胰管轮廓、测量其管径以及检测胰管扩张成为可能。对75例胰腺癌患者和45例慢性胰腺炎患者进行了CT扫描。胰腺癌患者中56%可见胰管扩张，肿瘤局限于胰头和胰体的患者中70%可见胰管扩张。平滑扩张（43%）或串珠样扩张（40%）最常与癌相关。慢性胰腺炎患者中58%存在胰管扩张，该组患者中73%可见不规则扩张。约一半有不规则扩张的患者胰管内有结石。27%的慢性胰腺炎病例中胰管轮廓与癌所见相似。癌患者的胰管管径有显著差异（P = 0.01），其管径更大。两种疾病之间胰腺宽度（P = 0.005）以及胰管管径与腺体宽度之比不同（P = 0.001）：慢性胰腺炎患者的腺体更宽，癌患者的胰管与腺体之比更大。在13例胰腺小癌（肿瘤大小为3 cm或更小）患者的亚组中，有8例出现胰管扩张但未检测到胰腺肿块。我们的研究结果表明，轮廓平滑且胰管与腺体总宽度之比为0.50或更大的扩张胰管提示潜在病理为癌。
