小肠腺癌的MSCT诊断  

Diagnostic Yield of MSCT in Small Bowel Adenocarcinoma

作　　者：唐永华[1] 缪飞[1] 陈克敏[1] 钟捷[2] 朱晖[1] 

机构地区：[1]上海交大医学院附属瑞金医院放射科 [2]上海交大医学院附属瑞金医院消化内科

出　　处：《中国医学计算机成像杂志》2008年第4期314-319,共6页Chinese Computed Medical Imaging

基　　金：上海市卫生局课题编号:05-Ⅲ-005-026~~

摘　　要：目的:探讨小肠腺癌(SBA)的多层螺旋CT(MSCT)表现及其诊断价值。材料和方法:回顾性分析56例经手术、小肠镜、病理确诊的小肠腺癌病人(除外壶腹部、壶腹部周围腺癌及转移癌)MSCT资料。结果:56例SBA病例,发生于十二指肠29例,空肠18例,回肠9例。MSCT定性诊断准确率为(51/56,91.1%),定位诊断准确率为(53/56,94.6%),根据病人的CT表现,可分为4型:缩窄型、溃疡浸润型、息肉肿块型、弥漫型,共有45例SBA行手术治疗,比较术前CT及与术后病理分期,Kappa检验表明两种分期方法有较高的一致性,另有21例同时行MSCT小肠造影及推进式双气囊小肠镜检查,两者术前定性、定位准确率均较高。结论:CT小肠造影对SBA术前定位、定性及分期诊断的准确率较高,可作为小肠疾病诊断的首选方法,掌握小肠腺癌MSCT表现,有助于提高SBA的影像学诊断水平。Purpose： To investigate the application and diagnosis value of MSCT in small bowel adenocarcinoma（SBA） .Materials and Methods： To retrospectively analyze MSCT data in 56 cases of SBA confirmed by histopathological diagnosis, who underwent either surgical operation or double - balloon enteroscopy（DBE） . Both periampullary tumors and those of ampulla of Vater and metastatic tumors of small bowel were excluded from the analysis. Results： In our series, lesions in 29 cases were located in duodenum, 18 in jejunum and 9 in ileum. Total localization and characterization accuracy of MSCT in diagnosing SBA were 91.1%, 94.6%, respectively. Based on morphology manifestation under CT, SBA were classified into 4 types, including constrictive type, ulcerated - infiltrative type, polypoid mass type and diffused type. CT staging before surgery and pathological staging after surgery were compared in 45 cases underwent operation. Kappa test showed high agreement between these 2 methods. MSCT enterography and DBE were carried in other 21 cases, the diagnostic accuracy in localization and characterization was also high. Conclusion： CT enterography in diagnosing SBA has high accuracy of localization, characterization and staging. This pilot study suggested that CT enterography has the potential clinical value in diagnosing of small bowel disease. Mastery of CT manifestation of SBA may improve the radiological diagnostic level.

关 键 词：小肠肿瘤 腺癌 体层摄影术.X线计算机 

分 类 号：R735.32[医药卫生—肿瘤]