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Objective: evaluation of multislice spiral computed tomography (MSCT), magnetic resonance imaging (MRI), ultrasound check (U.S.), endoscopic ultrasound (EUS) in periampullary cancer diagnosis in value. MATERIALS AND METHODS: retrospective analysis of 92 confirmed cases of ampullary carcinoma after radical surgical pathology imaging which MSCT76 cases, MRI 33 cases of U.S. 80 cases, EUS 30. Results: 18 cases of pancreatic cancer, 25 cases of the common bile duct end cancer, 38 cases of ampullary carcinoma, duodenal carcinoma 11 cases. Lymph node metastasis in 37 patients. 79 patients with low biliary obstruction, duodenal cancer, the incidence of obstructive jaundice significant difference (x2 = 20.923, P = 0.000) lower than other tumors. Common bile duct dilatation in 79 cases, and a diameter of 8 to 25mm, the average 16.10mm common bile duct dilatation between different tumors was statistically significant (x2 = 152.916, P = 0.021). 68 cases of dilated pancreatic duct diameter 1-13mm, 4.37mm, different tumor pancreatic duct dilatation was not statistically significant (x 2 = 25.677, P = 0.188). Common bile duct between the same degree of pancreatic duct dilatation was not statistically significant (P = 0.324). \\79 patients with biliary obstruction in pancreatic segment 23 cases, 34 cases of pancreatic within section 22 cases, ampullary segment, significant differences in the level of different tumor obstruction (x2 = 135.387, P = 0.000). The lumen morphology of The interrupt 39 cases, funnel-shaped or beak truncated type the interrupt 23 cases, rat tail type interrupt 17 cases, tumor obstruction of the lumen morphology significant difference (x 2 = 23.005, P = 0.001). The MSCT detectable tumor 82.9% (63/76), the detection of lesions are visible in varying degrees enhanced MSCT diagnosis of lymph node metastasis sensitivity 31.0%, specificity 97.9%, accuracy 72.4%. The MRI detected tumor 93.4% (31/33), enhanced scan 28 cases 26 See, for example, different degrees of strengthening. MRI diagnosis of lymph node metastasis, sensitivity 13.3%, specificity 94.4%, accuracy 57.6%. US detectable tumor in 47.5% (38/80), U.S. diagnosis of lymph node metastasis, sensitivity 8.6%, specificity 95.6%, accuracy 57.5%. EUS detected tumor 90.0% (27/30), EUS diagnosis of lymph node metastasis, sensitivity 16.7%, specificity 72.2%, accuracy of 50%. MSCT, MRI, EUS invasion of adjacent structures diagnostic sensitivity, specificity, and accuracy is quite different. Conclusion: US for detecting biliary obstruction, common bile duct dilatation trustworthy, subject to certain restrictions for the detection of pancreatic duct dilatation. MSCT or MRI should be used as the preferred method of examination of obstructive jaundice, MPR MRCP can clearly show the lesions of the biliary system. The enhanced performance of the different tumor differ MSCT multi-phase scan and MRI LAVA dynamic scanning conducive to the detection of lesions. EUS is the most sensitive examination of periampullary cancer. The lumen of obstruction level and obstruction surface morphological changes of great help for of periampullary cancer diagnosis and differential diagnosis. The truncated tail type interrupt, local discovered the tumor can be diagnosed as cancer. Common bile duct and pancreatic duct separation \Imaging diagnostic for tumor invasion of adjacent structures more tendentious views. Diagnostic imaging for lymph node metastasis only suggestive. Periampullary cancer diagnostic imaging requires a combination of modern diagnostic techniques, integrated application of various inspection methods.
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