15例小肠肿瘤性病变256层多排螺旋CT的诊断应用研究  

Application of 256 multidetector-row computed tomography enterography (MDCTE) in diagnosing small bowel tumor

作　　者：窦娅芳[1,2] 解骞[1] 唐颖[1] 朱全东[1] 祝瑞江[1] 梁宗辉[1,3] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]上海交通大学附属第一人民医院放射科,上海200080 [3]上海市静安区中心医院(复旦大学附属华山医院静安分院)放射科,上海200040

出　　处：《诊断学理论与实践》2012年第5期481-486,共6页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨256层多排螺旋CT小肠成像(MDCTE)扫描技术在小肠肿瘤性疾病诊断中的应用价值。方法:对118例临床疑似小肠疾病患者行256层MDCTE平扫及增强扫描,通过横断面及多平面重建,观察病变部位、大小、形态、周围侵犯及转移情况,结果与最终病理诊断进行对照分析。结果:本研究的118例患者中,小肠肿瘤15例,其中腺癌5例,误诊2例(2/15),影像表现为肠壁不规则增厚或分叶状肿块,近端肠道梗阻;间质瘤3例,表现为富血供肿块而无肠道梗阻;淋巴瘤1例,表现为小肠壁较长节段的不均匀增厚,肠腔反而扩张,病灶强化不明显;空肠平滑肌瘤1例,误诊为腺瘤(1/15),表现为肠壁不规则增厚,动静脉期强化不明显;肠系膜转移5例,漏诊2例(2/15),表现为肠系膜密度增高、腹腔内多发淋巴结肿大、腹水形成等。结论:小肠肿瘤性病变在MDCTE图像上具有特征性表现,MDCTE能全景式、多方位展示小肠肠道、肠系膜和系膜血管,对小肠肿瘤的诊断具有重要价值。Objective To study the application of 256-slice MDCTE for the evaluating of tumor of small bowel. Methods One hundred and eighteen patients （male 53; female 65; mean age 48.5 years） with symptoms of suspected small bowel diseases underwent 256-MDCTE were enrolled in this study. MDCTE and histopathology findings were ana- lyzed and reviewed. By cross-sectional and multiple plane reformation, the CT appearances of small-bowel tumor, inflam- matory bowel disease and other lesions affecting the small bowel were described and illustrated in detail. Associated com- plications and extra-enteric manifestations were also described. Results Of the 118 MDCTEs, there were 15 cases of small intestinal tumor, including 5 cases of adenocarcinoma （with 2 cases of misdiagnosis,2/15）, with CT sign of lobular mass and obstruction in proximal lumen. There were 3 cases of gastrointestinal stromal tumor （GIST）, showing masses rich in blood supply and without lumen obstruction; 1 case of lymphoma showing intestinal wall non-homogeneous thickening without lumen obstruction and even dilation, enhancement was not prominent; 1 case of jejunum leiomyoma misdiagnosed as adenocarcinoma （1/15）, exhibiting bowel wall thickening with slight enhancement.The 5 cases of mesenterie metastasis （with 2 cases of missing diagnosis, 2/15） demonstrating the presence of lymphadenopathy, ascites, etc.. Conclusions There are characteristic imaging features of small bowel tumor in MDCTE. MDCTE could illustrate the full view of small bowel with multi-planner reformation. MDCTE is useful for assessing small bowel tumor.

关 键 词：小肠 多层螺旋CT 诊断 

分 类 号：R656.7[医药卫生—外科学]