小儿消化道重复畸形的MSCT表现  

Multi-slice CT characteristics of gastro-intestinal tract duplication in children

作　　者：谢婵来[1] 龚英[1] 李国平[1] 帕米尔[1] 张大江[1] 王莉[1] 乔中伟[1] 缪飞[2] 

机构地区：[1]复旦大学附属儿科医院放射科,上海201102 [2]上海交通大学附属瑞金医院放射科,上海200025

出　　处：《放射学实践》2013年第4期463-466,共4页Radiologic Practice

基　　金：上海市科委生物医学重点项目(10411953200);上海市卫生局科研项目(2009Y017)

摘　　要：目的:探讨MSCT对小儿消化道重复畸形的诊断价值。方法:回顾性分析27例经手术病理证实的小儿消化道重复畸形病例,分析其CT表现,包括囊肿部位、形态、密度和囊壁厚度,并分析其相关并发症。结果:27例消化道重复畸形中发生在食管2例,胃3例,胃合并食管1例,小肠19例,结肠2例。囊肿形态在CT上表现为圆形23例、管形3例、圆形-管形复合型1例。25例囊肿CT平扫为液性低密度,1例合并囊内出血呈高密度,1例囊内可见气体。囊壁厚度大于同层面肠壁者有22例,囊壁均有强化,2例囊壁可见钙化。27例囊肿中,6例出现并发症,包括囊内出血1例,囊肿破裂穿孔伴胰腺炎1例,继发肠梗阻4例。结论:低密度液性囊肿(偶见气体)、厚壁、管形或圆形-管形复合型形态是消化道重复畸形特征性的CT表现。CT对诊断消化道重复畸形合并肠旋转不良、肠闭锁等畸形和(或)伴发肠梗阻、肠扭转等病变颇具优势。Objective：To assess the value of multi-slice CT （MSCT） in the diagnosis of gastro-intestinal tract （GI tract） duplication in children. Methods.. The MSCT findings of 27 children with surgery and pathology proven GI tract dupli- cation were retrospectively analyzed, including the location, size, density and wall thickness of duplication cyst, as well as the complications. Results： In Of these 27 cases, the duplication located at esophagus （n = 2）, storach and esophagus （n = 1）, stomach （n=3） ,small intestine （n= 19） and colon （n=2）. The shape of duplication cyst was round （n=23） ,tubular （n= 3） and round-tubular （n= 1）. On plain CT, the density of duplication cyst was fluid-like with low attenuation （n= 25）, but one presented as high density due to intra-cystic hemorrhage,and one with small amount of intra-cystic air. The cystic wall was thicker than the intestinal wall on the same slice （n=22） and all of the cystic wall enhanced after contrast administra- tion. Calcification of cystic wall was assessed in 2 cases. In 27 cases with duplication, complications including intra-cystic hemorrhage （n= 1）, cyst perforation associated with pancreatitis （n= 1） and secondary intestinal obstruction （n= 4）. Con- clusion：Low attenuated fluid-filled cyst （sometimes intra-cystic air could be assessed）, thickened wall, round or round-tubu- lar shape are the typical CT findings of GI tract duplication in children. MDCT is significantly superior in detecting GI tract duplication complicated with intestinal mal-rotation, atresia, and/or associated intestinal obstruction and volvulus.

关 键 词：儿童 消化道重复畸形 体层摄影术 X线计算机 

分 类 号：R816.92[医药卫生—放射医学]