Diagnostic Evaluation Of The Imageology Of Ampullary Malignant Tumor-report Of 25 Cases

Objective To evaluate the value of transabdominal ultrasound(US),16-slice computed tomography(CT),Magnetic Resonance Cholangiopancreatography(MRCP) and Endoscopic retrograde cholangiopancreatography(ERCP) in diagnosis of the Ampullary malignant tumor.Methods A retrospective study using the methods for the collection of the Fujian Provincial Hospital from September 2006 to November 2008 between the ERCP examination and confirmed by pathology in patients with Ampullary Cancer 25 cases, a comparative analysis of the detection and diagnosis of these 25 ampullary cancer among transabdominal ultrasound(US),16-slice CT,MRCP and ERCP will be done.Results Among the 25 cases of ampullary cancer,transabdominal ultrasound(US) had been performed in 24 patients,accounted for 96%,10 cases were detected,with a detection rate of 41.7%;CT had been performed in 15 patients,accounted for 60%, 9 cases were detected,with a detection rate of 60.0%;MRCP had been performed in 13 patients,accounted for 52%,9 cases were detected,with a detection rate of 69.2%;ERCP had been done for all the patients,24 cases were detected,with a detection rate of 96.0%.To the 24 cases which hed been done with US and ERCP, ERCP was more accurate than US in the assessment of the detection of ampullary cancer(96.8%for ERCP,41.7%for US,P<0.01);To the 15 cases which had been done with US,CT and ERCP,ERCP was more accurate than CT(93.3%for ERCP, 60.0%for CT,P=0.04),and CT was more accurate than US(60.0%for CT,20%for US,P=0.03) in the assessment of the detection of ampullary cancer;And to the 13 cases which had been done with US,MRCP and ERCP,ERCP was more accurate than MRCP(100%for ERCP,69.2%for MRCP,P=0.048),and MRCP was more accurate than US(69.2%for MRCP,23.1%for US,P=0.024).Conclusion1.Transabdominal ultrasound(US) which can do a very good location,qualitative effect in biliary tract disease and has a good detection rate in ampullary cancer may be as the first inspection to which ampullary cancer has been suspected from the combination of clinical symptoms,blood biochemical examination of patients.2.The superiority of 16-slice CT in accurately assessing the extent of the primary tumor,locoregional extension,vascular invasion and distant metastases is good to surgery for decision-making with ampullary cancer,and the 16-slice CT can be used as the main check of the preoperative assessment of TNM staging of ampullary cancer.3.MRCP has a high sensitivity and specificity in the evaluation of pancreaticobiliary disease,but it can not replaced ERCP completely in diagnosis of ampullary cancer.4.With a high degree of sensitivity,and practical examination and interventional therapy,ERCP can Provide supplementary diagnostic for the patients who were performed with slice CT or MRCP and the diagnosis is still not clear,also can use to the patients who with ampullary carcinoma need to intervene.