MSCT多平面重组技术在十二指肠降部病变诊断中的价值  

The diagnostic value of MSCT MPR technique in descending duodenum diseases

作　　者：李冬飞[1] 范国华[1] 

机构地区：[1]苏州大学附属第二医院影像科,江苏苏州215004

出　　处：《实用放射学杂志》2015年第12期2046-2049,共4页Journal of Practical Radiology

摘　　要：目的 探讨多层螺旋CT（MSCT）多平面重组（MPR）技术在十二指肠降部病变诊断中的价值。方法 对48例经病理证实的十二指肠降部病变的MSCT图像进行MPR后处理，分析病变的形态、部位、累及范围及强化程度。结果 原发性十二指肠降部恶性肿瘤26例，其中腺癌25例，腺鳞癌1例；炎症16例；间质瘤5例；乳腺癌转移至十二指肠大乳头1例。十二指肠降部壶腹区（包括十二指肠大乳头部及Vater’s壶腹）癌表现为壶腹区软组织肿块，增强扫描肿块有轻中度强化，伴肝内外胆管扩张，非壶腹区腺癌表现为肠壁不规则增厚，肠腔狭窄，增强扫描增厚肠壁呈中度强化；炎症表现为十二指肠降部肠壁局部增厚，边缘光整，增强扫描呈明显均匀强化，乳头部炎症表现为乳头增大，常伴肝内外胆管扩张；间质瘤表现为边界清楚的囊实性或实性软组织肿块伴明显、不均匀强化；乳腺癌转移至十二指肠大乳头表现为乳头部结节灶，增强呈中度强化。静脉期腺癌与炎症强化程度比较差异有统计学意义（P〈0.05）；动脉期炎症与间质瘤强化程度比较差异有统计学意义（P〈0.05）；动脉期及静脉期腺癌与间质瘤的强化程度比较差异均有统计学意义（P〈0.05）；余各病变各期之间强化程度比较差异无统计学意义（P〉0.05）。结论 MSCT MPR技术能准确、直观地显示十二指肠降部病变的形态、部位、累及范围及其强化程度，为疾病诊断及治疗方案的制订提供更丰富的信息。Objective To investigate the diagnostic value of multislice spiral CT （MSCT} MPR （multiple plane reformation} technique in descending duodenum diseases. Methods Post-processing technique MPR was done in 48 patients with the descending duodedum diseases proved by pathology, and the morphology, location, involved range and enhancement degree of the diseases were analyzed. Results There were 26 primary malignant tumors in the descending duodenum, including 25 adenocarcinomas and 1 adenosquamous carcinoma. 16 inflammatory lesions, 5 stromal tumors and 1 metastasis from breast carcinoma with involvement of the major duodenal papilla were also included. Duodenal ampulla （including major papilla and Vater＇s ampulla） carcinoma manifested as local soft tissue mass, and enhanced CT showed the mass with mild or moderate enhancement and dilated intrahepatic and extrahepatic biliary duct. Non-ampulla carcinoma manifested as local irregular thickening of duodenal wall in accompany with constriction of cavity, and enhanced CT showed the thickened wall with moderate enhancement. Inflammatory lesions manifested as local thickening of duodenal wall with smooth border and homogeneous marked enhancement, and the inflamation of the major papilla manifested as increased volume, usually accompanied with dilated intrahepatie and extrahepatic biliary duct. Stromal tumor manifested as solidary or cyst-solitary soft tissue mass with smooth border and heterogeneous marked enhancement. Duodenal papilla metastasis arised from breast carcinoma manifested as a local nodule with moderate enhancement. There were statistical significances in enhanced patterns between the adenocarcinoma and inflamation in venous phase （P〈0.05）, between inflamation and stromal tumor in arterial phase （P〈0.05）, and between adenocarcinoma and stromal tumor in both arterial and venous phases （P〈0.05）. No differences be tween the other different diseases and phases were significant （P〉0.05）. Conclusion MPR technique of MSCT can display

关 键 词：十二指肠病变 计算机体层成像 多平面重组 

分 类 号：R574.51[医药卫生—消化系统] R814.42[医药卫生—内科学]