Đặc điểm hình ảnh của ung thư bóng Vater và ung thư đầu tụy quanh bóng Vater trên cộng hưởng từ

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Tác giả: Quang Huy Huỳnh, Diễm Phương Lâm, Xuân Quỳnh Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.181

Bộ sưu tập: Metadata

ID: 339325

Thêm vào giỏ Liên kết toàn văn

- Mục tiêu: Mô tả đặc điểm hình ảnh của ung thư bóng Vater và ung thư đầu tụy quanh bóng Vater trên cộng hưởng từ.- Đối tương, phương pháp: Bao gồm 16 bệnh nhân ung thư bóng Vater và 12 bệnh nhân ung thư đầu tụy quanh bóng Vater được chẩn đoán và điều trị tại bệnh viện Bình Dân thành phố Hồ Chí Minh từ 1/1/2019 đến 31/7/2021. Thiết kế nghiên cứu hồi cứu, mô tả hàng loạt ca. Tất cả bệnh nhân được ghi hình bằng máy CHT 1,5 Tesla (máy Signa HDx của hãng GE) tại khoa Chẩn đoán hình ảnh bệnh viện Bình Dân.- Kết quả: Ung thư bóng Vater có kích thước nhỏ (khoảng 15.19 mm), có tín hiệu đa dạng trên hình T1W, T2W. Đa số u bắt thuốc kém so với nhu mô tụy bình thường. OMC dãn trên tất cả bệnh nhân ung thư bóng Vater, trong đó có khoảng 50% bệnh nhân có dãn OTC (dấu hiệu ống đôi). Khoảng cách từ điểm cuối OMC và OTC bị dãn đến nhú tá lớn ngắn (lần lượt là 10.38 ± 4,00 mm và 10.37 ±3,92 mm), góc tạo bởi OMC và OTC nhỏ (22,94 ± 8,71 độ). Khoảng 56,25% u dạng nốt và 43,75% u dạng dày quanh ống, 50% có hình ảnh bóng Vater lồi vào tá tràng. Ung thư đầu tụy có kích thước lớn (khoảng 29,75 mm), có tín hiệu thấp trên hình T1W, thường có tín hiệu cao trên hình T2W, bắt thuốc kém hơn nhu mô tụy bình thường. OMC dãn ở tất cả các bệnh nhân, trong đó có 83,33% dãn OTC (dấu hiệu ống đôi). Một số bệnh nhân có dấu hiệu ba đoạn hoặc dấu hiệu bốn đoạn. Khoảng cách từ điểm cuối OMC và OTC bị dãn đến nhú tá lớn dài (lần lượt là 30.33 ± 16,60 mm và 31.90 ± 14,20 mm), góc tạo bởi OMC và OTC lớn (54,17 ± 20,27 độ).- Kết luận: Cộng hưởng từ là phương tiện hữu ích trong chẩn đoán phân biệt ung thư bóng Vater và ung thư đầu tụy quanh bóng Vater.Abstract- Objectives: To describe the characteristics of ampulla of vater, pancreatic head and periampullary cancer on magnetic resonance imaging.- Methods: A retrospective study was conducted on 16 patients with ampulla of Vater cancer and 12 patients with periampullary cancer who wereadmitted at Binh Dan hospital in Ho Chi Minh City between January 2019 and July 2021. All patients were performed with a 1.5 Tesla MRI machine (GE’s Signa HDx machine) at the Diagnostic Imaging Department of Binh Dan Hospital.- Results: Ampulla of Vater tumors were small (about 15.19 mm), with the diverse signal on T1W, T2W images. Most tumors were poorly enhanced as compared with normal pancreatic parenchyma. The bile ductwas dilated in all patients with ampulla of Vater, of which approximately 50% of patients hadpancreatic duct dilatation (double duct sign). The distance from the dilated bile ductand pancreatic ductendpoints to the large papillae was short (10.38 ± 4.00 mm and 10.37 ± 3.92 mm, respectively), the angle formed by the bile ductand pancreatic ductwas small (22.94 ± 8.71 degrees). About 56.25% of tumors were nodular, and 43.75% were thickened peritubular tumors, 50% hadampulla of Vater protruding into the duodenum. Pancreatic head tumors were large (about 29.75 mm), low - intense on T1 - weighted images, often high - intense on T2 - weighted images, and had poorer enhancement than normal pancreatic parenchyma. Bile ductdilated in all patients, 83.33% dilated pancreatic duct (double tube sign). Some patients had the trisegment sign or the quadruple sign. The distance from the dilated bile ductand pancreatic ductendpoints to the long large papillae were 30.33 ± 16.60 mm and 31.90 ± 14.20 mm, respectively, the angle formed by the bile ductand pancreatic ductwas large (54.17 ± 20.27 degrees). ).- Conclusion: Magnetic resonance is a useful tool in the differential diagnosis of the ampulla of Vater, pancreatic head and periampullary cancer. DOI: 10.59715/pntjmp.1.2.21

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