小肠出血性间质瘤的影像学诊断比较分析  

Imaging Diagnosis of Hemorrhagic Interstitialoma of Intestine

作　　者：倪志华 嵇鸣[1] 宋恬[1] 孙荣跃[1] 吴堪华 殷士蒙[1] 

机构地区：[1]复旦大学附属华东医院放射科

出　　处：《中国医学计算机成像杂志》2013年第6期528-531,共4页Chinese Computed Medical Imaging

基　　金：上海市青年医师培养资助计划~~

摘　　要：目的:探讨小肠间质瘤的影像学表现及主要影像学检查的技术要点,以提高对该类疾病的认识和诊断阳性率。方法:收集病理诊断为间质瘤的小肠出血病例17例,经数字减影血管造影(DSA)、小肠体层扫描(CT)、小肠稀钡造影检查。回顾性分析其临床特点、影像学表现。结果:DSA全腹部造影能发现早现的异常血管、微导管造影能发现长径3cm以下的肿瘤染色;CT检查前小肠扩张充盈准备要求高,止血成功后择期检查CT阳性率(88.2%)高于DSA(82.4%)和小肠稀钡造影(70.6%);但对长径3cm以下肿瘤不敏感;小肠稀钡造影受周围肠道内对比剂遮挡而容易漏诊。结论:DSA能发现小肠间质瘤出血急性期的异常血管;患者生命体征平稳后择期CT检查有助于病灶的检出,且需要DSA的定位帮助;小肠稀钡造影阳性对术前定位有较大帮助。Purpose： To discuss the imaging manifestations of intestinal interstitialoma and key points of imaging examinations so as to improve the understanding of the disease and positive rate of diagnosis. Methods： Seventeen cases of intestinal bleeding which were pathologically diagnosed as interstitialomas were collected. Their clinical features and imaging manifestations through digital subtraction angiography（DSA）, computed tomography（CT）, and thin barium examination of the small intestine were analyzed. Results： All abdominal angiography by DSA showed early abnormal blood vessels, micro-catheter angiography showed tumor staining whose diameter was less than 3cm; Higher requirements were needed for expansion and filling of the intestine before CT and the CT positive rate was 88.2%, higher than DSA and thin barium exam which were 82.4% and 70.6% respectively after hemostatic success. However, it was not sensitive for tumor under 3cm in diameter; Thin barium contrast of the intestine was inclined to be shielded by contrast material from surrounding intestines and could easily cause missed diagnosis. Conclusion： DSA can find abnormal blood vessels caused by interstitialoma of intestine hemorrhage at acute stage; with the help of DSA localization, CT is conducive to the detection of lesions when vital signs of patient are stable; of thin barium contrast of the small intestine is helpful for location before operation.

关 键 词：小肠出血 间质瘤 数字血管造影 体层摄影术 X线计算机 

分 类 号：R735.3[医药卫生—肿瘤]