Brunner 腺腺瘤的多排螺旋 CT 征象与病理表现  

Comparative study of CT and pathological findings in Brunner’s gland adenoma

作　　者：周玉祥[1] 饶红萍[1] 代海洋[1] 易智君[1] 钟柳城[2] 黎昕[1] 

机构地区：[1]惠州市中心人民医院放射科,广东惠州516001 [2]惠州市第一人民医院放射科

出　　处：《实用放射学杂志》2015年第6期958-961,共4页Journal of Practical Radiology

摘　　要：目的：探讨 Brunner 腺腺瘤的 CT 表现及诊断要点。方法回顾性分析经病理证实的9例 Brunner 腺腺瘤的 CT 特征及病理改变,分析病灶数目、部位、大小、形态、边缘、密度、强化模式等情况,并观察其组织病理学表现。结果9例中位于胃窦部1例,位于十二指肠8例,其中球部6例（75%）,乳头处2例（25%）；6例球部病变中,前壁3例,后壁3例。除1例并发肠炎导致边界不清外,其余8例病灶均示边界清楚,呈类圆形、结节状,最大径约15~68 mm（平均35.0 mm±16.2 mm）。CT 平扫呈等密度,绒毛状,未见坏死、出血。增强扫描动脉期病灶与正常肠壁强化程度相当,显示黏膜环状明显强化（光环征）6例,病灶内点状无强化区（黑星征）5例,增粗或迂曲强化血管影6例；静脉期病灶延迟强化9例,5例“黑星征”或“黑线征”显示更清晰。病理上病灶外观呈鱼肉状,实性或囊性；光镜下表面覆盖正常十二指肠黏膜,Brunner 腺结节状增生,见平滑肌束分隔,伴有腺体内导管扩张、囊肿、脂肪细胞,1例伴部分腺上皮轻度非典型增生,1例见异位胰腺。结论Brunner 腺腺瘤的 CT 表现具有一定特征性,对术前准确诊断具有重要价值。Objective To investigate the imaging findings and key diagnostic points of Brunner’s gland adenoma on CT.Methods The CT imaging findings and pathological features of 9 cases of Brunner’s gland adenoma confirmed by pathology were retrospec-tively analyzed,including the lesions number,site,size,shape,margin,density and the enhancement pattern.Results Of the 9 ca-ses,1 case located in the antrum and 8 cases in the duodenaum [6 cases in the duodenal bulb （75%）and 2 in the papillary （25%）]. Of the 6 cases of duodenal lesions,3 were found at the anterior wall and 3 at the posterior wall.Except 1 case which complicated with enteritis and had an obscure margin,the other 8 cases were clear margined ,and were round or nodular in shape.The maximum size of tumors ranged 1 5-68 mm in diameters （mean 35.0 mm ± 1 6.2 mm）.The density of tumors was homogeneous on CT scan without necrosis or hemorrhage.In the arterial phase after administration of contrast agent,the lesions were similar to the adjacent intestinal wall enhancement,and mucosal annular enhancement （halo sign）showed in 6 cases,and the dot-shape non-enhancement area within the lesion （black star sign）showed in 5 cases,and the thickening or tortuous enhanced blood vessel showed in 6 cases.In the venous phase,9 cases were progressive enhancement,and the “black star sign”or “the black line sign”showed more clearly in 5 cases.In the pathology,the lesions were polypoid-like,solid or cystic.Under the microscope,the hyperplasic Brunner’s glands were covered with normal duodenal mucosa and separated by bundles of smooth muscle cells with dilated duct,cyst,and adipose cells,1 case with atypical hyperplasia of the glandular epithelium and 1 case with ectopic pancreas.Conclusion There are some spe-cific CT imaging features in Brunner’s gland adenoma,which is of important clinical value in accurate preoperative diagnostic.

关 键 词：BRUNNER腺腺瘤 十二指肠 计算机体层成像 

分 类 号：R735.31[医药卫生—肿瘤] R814.42[医药卫生—临床医学]