The Diagnostics Value Research Of CT Scan And Duodenal Endoscopy Technology Combined’s Contribution To Periampullary Carcinoma

Objective : To investigate the value of CT scanning and enhanced duodenal endoscopy technology combined Periampullary diagnosis, improve periampullary cancer diagnostic sensitivity, accuracy and specificity of clinical misdiagnosis rate and reduce the rate of misdiagnosis, periampullary lesions characteristic makes the display more comprehensive and accurate, for periampullary cancer early detection, early diagnosis and early treatment to help.Methods:Collected in our hospital from diagnosis from January 2010 to January 2015 period periampullary cancer patients 23 cases. All patients underwent 64-slice CT scan, phase enhanced scans were done to check for bowel preparation before hypotonic drinking water. While all the patients underwent duodenal endoscopy, where for individual patients on the basis of passing duodenal endoscopy endoscopic retrograde cholangiopancreatography(ERCP) examination, and all patients were biopsy for pathological examination. By comparing and analyzing Periampullary enhanced CT imaging scans and duodenal endoscopy and biopsy and the results were compared, analyzed the two inspection techniques alone and in combination with different types of periampullary diagnostic sensitivity, accuracy, specificity and rate of misdiagnosis and missed diagnosis rate. Meanwhile judge alone two inspection techniques and their combination periampullary lesions characteristic display case, using SPSS17.0 statistical analysis software package for data analysis, statistical methods using paired design chi-square test, P <0.05 was considered statistically significant difference.Results:23 cases of patients with periampullary cancer, duodenal cancer three cases, five cases of ampullary carcinoma, 7 cases of bile duct cancer end, eight cases of pancreatic cancer.Statistical results showed that:1, CT enhanced scan shows not only direct signs of the tumor, may also show the tumor and surrounding tissue, the relationship between blood vessels, lymph node metastasis and distant organ metastasis and indirect signs of pancreatic fat around the availability of space and so on. Where the sensitivity and accuracy of the diagnosis of pancreatic cancer is relatively high. Where for bowel wall thickening and dilation of bile duct lesions characteristic display is better, the situation through the expansion of bile duct obstruction can indirectly determine the location or bile duct stenosis, Periampullary help improve the accuracy of diagnosis sex. But the CT scan is more difficult for the duodenal mucosa and papillary morphology, intestine and gall bladder, and pancreatic duct stenosis diameter less than 2cm lesion characteristics tiny tumors showed that tumor growth and therefore can not be the way in the cavity and effective performance evaluation form, may cause missed or misdiagnosed. Duodenoscopy feasible at this time, or ERCP examination technique further examination.2, duodenal endoscopy technology forms can be observed in the duodenal mucosa and nipple under direct vision, for the intestine and gall bladder, small tumors 2cm lesion characteristics such as pancreatic duct dilatation and stenosis diameter less than or display obvious advantages. Where for duodenal cancer diagnostic sensitivity and accuracy is relatively high. Through the intestine and bile duct stenosis conditions can also indirectly determine the position of the intestine and gall bladder obstruction, pancreatic duct dilatation. Especially in the duodenum endoscopy ERCP examination on the basis of technology, for bile duct dilatation or stenosis show higher sensitivity and accuracy. But it can not observe the tumor and surrounding tissue, the relationship between blood vessels and lymph node metastasis and distant organ metastasis and other indirect signs. CT scan feasible at this time for further examination.3, CT enhanced scan and duodenal endoscopy technology combined with either tumor effective way to display and evaluate the growth chamber, shape performance and bile duct, expansion or stenosis of the intestine, they can effective detection is missed or misdiagnosed by CT examination of the lumen diameter <2cm or more tiny tumors. Also can show the relationship between the tumor and surrounding tissue or blood vessels, lymph node metastasis and distant organ metastasis indirect signs. Combined the two inspection technology to improve the different types of periampullary cancer diagnostic sensitivity and accuracy, reducing the rate of misdiagnosis, the complementary advantages.Statistical analysis showed, CT scans and enhanced duodenal endoscopy technology combined to Periampullary cavity, external cavity lesion characteristics showed that complementarity is very obvious, so periampullary lesions characteristic display more comprehensive and accurate and also increased its periampullary diagnostic sensitivity and accuracy, reducing the rate of misdiagnosis and clinical misdiagnosis rate, with a statistically significant difference.Conclusion : CT scan and two examination techniques duodenoscopy around ampullary cancer lesions characteristic display their own advantages and disadvantages of the two inspection techniques alone may cause missed or misdiagnosed. Check the complementary strengths of the two technologies is very clear, through the combination of the two technologies can not only check the cycle of ampullary carcinoma lesions show features more comprehensive and accurate, but also can effectively reduce the rate of misdiagnosis and clinical misdiagnosis rate, ultimately improve diagnostic sensitivity, accuracy and specificity for early periampullary cancer detection, early diagnosis and early treatment to help.