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Gem CT clinical study in the diagnosis of periampullary carcinomas spectrum analysis

Author: BaiRongRong
Tutor: ZhengJin
School: Yangzhou University
Course: Medical Imaging and Nuclear Medicine
Keywords: Periampullary carcinomas Gem CT spectrum imaging
CLC: R816.5
Type: Master's thesis
Year: 2013
Downloads: 21
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Abstract


Periampullary carcinomas, also named pancreaticobiliary ductal and duodenal union carcinomas (PDDU), refer to malignant neoplasm originated from the Vater ampulla、epithelium of cholidoch or pancreatic duct of pancreatic head, and mucosa of duodenal papilla and its surrounding(with papilla opening as the center, diameter2cm area). The anatomical structure of ampulla is complicated, the tissue origin of the tumor occurring in the part is diversity, and they have the same clinical manifestation (often obstructive jaundice is the initial symptom) and similar imaging signs (including soft tissue mass around ampulla, dilation of CBD or PD and so on). As a result, the diagnosis and differential diagnosis have been a difficulty of imaging inspection. Due to the different origin and biological behavior, the tumor incidence, surgical resection and prognosis are different. Accurate diagnosis of tumor is very important to the choice of reasonable treatment and prognosis prediction. At present there are many clinical imaging inspection methods (including US、CT、MRI、MRCP ect) for ampullary carcinomas. With the development of technology, comprehensive application of kinds of inspection methods can clearly display the shape, size of the ampullary carcinoma and its relation with surrounding structures, providing reliable basis for early diagnosis. But these inspection methods can only diagnose ampullary mass, they cannot identify the source of tumor. This study intended to comprehensive apply multiple parameter incluing characteristic spectrum curve, different base material, effective atomic number and etc of Gem spectrum CT (Discovery CT750HD), probing the diagnostic value of spectrum CT for ampullary carcinomas. This research mainly divided into clinical data collection, image scanning and processing and data analysis.Objective Probe the value of gem CT spectrum analysis in the diagnosis of vater ampulla carcinomas.Methods Respectively analyse the imaging data of30cases with vater ampulla carcinomas (including15pancreatic head carcinomas,9duodenal papillary carcinomas and6commom duct lower segment carcinomas), compare the results with surgical pathology. All the patients accepted double period scanning Gemstone CT Spectrum Imaging, obtaining140kVp QC and70keV mono imaging. Measure the focus in the portal vein phase and record the relevant data (including the CT value from40keV to100keV, iodine-water concentration, Effective-Z and spectrum curve), calculate the curve slope(50~100keV), dispose the data for statistical analysis.Results In the portal vein phase and low energy level(50~100keV), the CT value of pancreatic head carcinoma was obvious lower than duodenal papillary carcinoma and commom duct lower segment carcinoma, while the CT value of duodenal papillary carcinoma was lower than commom duct lower segment carcinoma. Performance on CT spectrum curve was the differences among slope (the average slope of pancreatic head carcinoma was0.75±0.18, duodenal papillary carcinoma was1.61±0.39, commom duct lower segment carcinoma was2.22±0.41). The average iodine concentration of pancreatic head carcinoma (7.17g/L±0.96g/L) and E-Z (7.92±0.41) were lower than that of duodenal papillary carcinoma (18.10g/L±1.57g/L,8.54±0.26) and commom duct lower segment carcinoma (23.21g/L±3.50g/L,8.72±0.48). The average iodine concentration of duodenal papillary carcinoma was obviously lower than that of commom duct lower segment carcinoma, while there was no significant difference between the E-Z of the two. There were no significant differences among the water concentration of the three (the water concentration of pancreatic head carcinoma was1024.64±16.02, duodenal papillary carcinoma1018.92±12.16,commom duct lower segment carcinoma1013.36±12.86).Conclusion Different pathological types of vater ampulla carcinomas have their own spectrum characteristics. Gemstone CT Spectrum Analysis has certain value for differential diagnosis of vater ampulla carcinomas.

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CLC: > Medicine, health > Of Medical > Radiation Medicine > Each location and course of disease X - ray diagnosis and therapy > Stomach and digestive
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