回盲部结核、癌与淋巴瘤的CT扫描特征分析  

Analysis of CT signs of ileocecal tuberculosis,carcinoma and lymphoma

作　　者：洪盟 过丽芳 郭佳 关晓姣 王仁贵 HONG Meng;GUO Li-fang;GUO Jia;GUAN Xiao-jiao;WANG Ren-gui(Department of Radiology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院放射科,100038

出　　处：《中国防痨杂志》2020年第3期215-221,共7页Chinese Journal of Antituberculosis

摘　　要：目的分析回盲部结核、癌与淋巴瘤的CT表现特点.提高回盲部疾病的诊断及鉴别诊断水平。方法回顾性分析2008年2月至2019年9月首都医科大学附属北京世纪坛医院影像资料库的回盲部结核16例(结核组)、回盲部癌40例(癌症组)、回盲部淋巴瘤14例(淋巴瘤组)患者资料.比较3组疾病的CT表现特征。结果⑴结核组、癌症组与淋巴瘤组病变肠管长度分别为(9.5±2.9)cm.(4.7±1.4)cm,(9.0±2.7)cm.结核组与癌症组、癌症组与淋巴瘤组比较,差异均有统计学意义(t=8.046,P=0.000;t=7.309,P=0.000).三组病变肠管厚度分别为(1.6±0.3)cm,(2.3±0.7)cm,(2.3±0.6)cm.结核组与癌症组、结核组与淋巴瘤组比较.差异均有统计学意义(r=3.177,P=0.002,χ2=2.082,P=0.037)。(2)结核组与淋巴瘤组主要表现为肠壁较均匀增厚,三组肠壁较均匀增厚发生率分别为62.5%(10/16)、22.5%(9/40)、57.1%(8/14).结核组与癌症组、癌症组与淋巴瘤组比较,差异均有统计学意义(χ2=8.157,P=0.004;χ2=5.770.P=0.016);癌症组主要表现为肠壁不规则呈肿块样病灶,三组出现肠壁不规则呈肿块样病灶的发生率分别为37.5%(6/16)、77.5%(31/40)、42.9%(6/14).结核组与癌症组、癌症组与淋巴瘤组比较,差异均有统计学意义(χ2=8.157,P=0.004;χ2=5.770,P=0.016).三组出现病变肠管与正常肠管分界模糊的发生率分别为87.5%(14/16)、30.0%(12/40)、21.4%(3/14).结核组与癌症组、结核组与淋巴瘤组比较,差异均有统计学意义(χ2=15.190,P=0.000;Fisher确切概率法P=0.001).三组出现肠周轻度“浑浊征”的发生率分别为25.0%(4/16),77.5%(31/40)、92.9%(13/14).结核组与癌症组、结核组与淋巴瘤组比较,差异均有统计学意义(χ2=13.440.P=0.000;Fisher确切概率法P=0.000);结核组、癌症组与淋巴瘤组出现肠周重度“浑浊征”的发生率分别为75.0%(12/16)、22.5%(9/40)、7.1%(1/14).结核组与癌症组、结核组与淋巴瘤组比较,差异均有统计学意义(χ2=13Objective To investigate the characteristics of CT signs in ileocecal tuberculosis,cancer and lymphoma,and to improve the diagnosis and differential diagnosis of ileocecal diseases.Methods The data of 16 cases of ileocecal tuberculosis(tuberculosis group),40 cases of ileocecal carcinoma(cancer group)and 14 cases of ileocecal lymphoma(lymphoma group)from the imaging database of Beijing Shijitan Hospital affiliated to Capital Medical University from February 2008 to September 2019 were retrospectively analyzed,and the CT features of the three groups of diseases were compared.Results(1)The intestinal length of ileocecal tuberculosis,cancer and lymphoma were(9.5±2.9)cm,(4.7±1.4)cm,and(9.0±2.7)cm respectively,and the differences of intestinal length were statistically significant(χ2=8.046.P=0.000;χ2=7.309,P=0.000).The thicknesses of diseased intestine in three groups were(1.6±0.3)cm,(2.3±0.7)cm.and(2.3±0.6)cm,and the differences of thickness of diseased intestine were statistically significant,between the tuberculosis group and the cancer group,the tuberculosis group and the lymphoma group(χ2=3.177,P=0.002;χ2=2.082.P=0.037).(2)The tuberculosis group and the lymphoma group mainly showed uniform thickening of the intestinal wall.The incidence rates of homogeneous thickening of the intestinal wall in the three groups were 62.5%(10/16),22.5%(9/40)and 57.1%(8/14),and the differences were statistically significant between the tuberculosis group and the cancer group,the cancer group and the lymphoma group χ2=8.157,P=0.004;χ2=5.770,P=0.016).The main manifestation of the cancer group was irregular lump-like lesions in the intestinal wall.The incidence rates of irregular thickening of the intestinal wall in the three groups were 37.5%(6/16),77.5%(31/40)and 42.9%(6/14),and the differences were statistically significant between the tuberculosis group and the cancer group,the cancer group and the lymphoma group(χ2=8.157,P=0.004;χ2=5.770,P=0.016).The incidence rates of fuzzy boundary between healthy and pathologic int

关 键 词：回肠疾病 盲肠疾病 结核 胃肠 回肠肿瘤 体层摄影术 X线计算机 疾病特征 诊断 鉴别 

分 类 号：R735.36[医药卫生—肿瘤] R524[医药卫生—临床医学]