目的 研究多层螺旋CT扫描与CT 灌注成像在胰腺癌成像中诊断价值及差 异。方法 回顾性分析44例胰腺癌患者的 临床资料，所有患者均采取多层螺旋CT扫 描与CT灌注成像检查，其中多层螺旋CT扫 描包括平扫、多期增强扫描；对比平扫、 动脉期、胰腺期、门脉期对胰腺癌的检出 率，对比分析胰腺癌组织与正常胰腺组 织的密度、血流量(BF)、血容量(BV)、 平均通过时间(MTT)和表面通透性(PS)的 检测值。结果 在多层螺旋CT扫描中，胰 腺期对胰腺癌的检出率最高，胰腺期、门 脉期对胰腺癌的检出率无显著性差异(P＞ 0.05)，但均显著大于平扫、动脉期对胰 腺癌的检出率(P＜0.05)；多层螺旋CT多 期增强扫描胰腺癌组织与正常胰腺组织的 密度值具有显著性差异(P＜0.05)；胰腺 期的CT差值显著大于动脉期、门脉期(P ＜0.05)；多层螺旋CT平扫胰腺癌组织与 正常胰腺组织的密度值无显著性差异(P＞ 0.05)；在CT灌注成像中，胰腺癌组织的 BF、BV及PS的检测值小于正常胰腺组织， MTT的检测值大于正常胰腺组织；两组数 据具有显著性差异(P＜0.05)。结论 多层 螺旋CT灌注成像对胰腺癌的诊断有重要参 考价值，灌注参数BF、BV、MTT及PS对胰 腺癌的诊断和鉴别诊断价值大。

Objective To investigate the value and differentiation of multislice computed tomography scanning and perfusion for pancreatic carcinoma imaging. Methods The clinical data of 44 patients with pancreatic carcinoma were analyzed retrospectively. All the patients received multislice computed tomography scanning and perfusion. Multislice computed tomography scanning included plain scan and multi-phase scan. The prevalence of pancreatic carcinoma at different time (plain scan phase, arterial phase, portal venous phase, pancreatic phase) was compared. The blood flow(BF), blood volume (BV), permeability surface(PS), mean transit time (MTT) were measured and compared between the pancreatic carcinoma and the normal pancreatic tissue. Results In the multislice computed tomography scanning, the positive rate of pancreatic carcinoma at pancreatic phase was the highest. There was no significantly difference for detection of pancreatic carcinoma between portal venous phase and pancreatic phase. And the positive rate of pancreatic carcinoma at portal venous phase and pancreatic phase were higher than that at plain scan phase and arterial phase. And there was significantly difference. The density value in multi-phase scan between the pancreatic carcinoma and the normal pancreatic tissue was significantly difference(P<0.05). The CT differential value at pancreatic phase was higher than that at arterial phase and portal venous phase(P<0.05). In multislice computed tomography scanning, the density value between the pancreatic carcinoma and the normal pancreatic tissue was no difference. In CT perfusion imaging, BF, BV and PS value of pancreatic tumor were less than those in normal pancreatic tissue. While MTT value was more than that of normal pancreatic tissue. There was significantly difference between them. Conclusion Multislice computed tomography perfusion imaging plays an critical role in diagnosis of pancreatic cancer and BF, BV, MTT and PS diagnosis and differential diagnosis of pancreatic tumor were more.