医学影像英语每日读丨110.CT Imaging of Solid Pancreatic Tumors (part6)

每天朗读一段医学影像学英语文章

朗读者：YWT领读

Notes:

1. neuroendocrine  [nju:rə'endəkraɪn] adj. 神经内分泌的

2. adenocarcinoma [ˌædnoʊˌkɑ:sə'noʊmə] n. 腺癌

3. vasculature ['væskjələˌtʃə] n. 脉管系统

4. parenchyma [pə'reŋkɪmə] n. 实质

5. occult  [ˈɑ:kʌlt] adj. 隐匿性的

Unlike the tumor we're going to talk about later, neuroendocrine tumors, it is going to be very difficult for an adenocarcinoma for you to draw discrete margins around the tumor. And in many cases, it can be very difficult to actually measure the tumor discretely.

Now not only does this tumor infiltrate,it's often gonna have a tendency to encase adjacent vasculature, and it will tend to involve the common bile duct and the pancreatic duct,obstructing both of those.

Here's a relatively typical pancreatic adenocarcinoma. Notice that it's hypodense, it's poorly enhancing, it is relatively ill-defined and poorly marginated. And you can see that in the second image on the bottom-right, it is obstructing the pancreatic duct with abrupt cutoff at the level of the mass.

Now in most cases, you're gonna be able to see the lesion. But I will warn you there are five to ten percent of pancreatic cancers where you are not gonna be able to find the lesion on CT. In these cases the lesion is gonna be essentially isoattenuating to the pancreatic parenchyma on both the arterial and venous phase. And in such instances you are gonna have to look for secondary signs of tumor which is gonna alert you to the presence of an occult tumor.

翻译：坚持学习

胰腺实性肿瘤的CT表现 part6

不同于我们接下来要讲到的胰腺内分泌肿瘤，对于胰腺腺癌，我们很难划分边界。在很多病例中，很难去准确测量肿瘤。

腺癌不仅呈浸润性生长，它还经常有包绕临近脉管结构的趋势，它可能侵及总胆管和胰管，阻塞二者。

这是一例相当典型的胰腺腺癌。它低密度，基本不强化，边界不清。右下角的第二幅图，它阻塞了胰管，在肿瘤层面胰管突然截断。

在大多数病例中，我们能够发现病灶。但是需要注意，有5-10％的胰腺肿瘤，我们在CT上不能发现。在这些病例中，不管是动脉期还是静脉期，病灶和胰腺实质都是等密度。这时你需要寻找肿瘤的间接征象，能够帮助你找到隐匿性肿瘤的存在。

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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