结合内镜分析异位胰腺的CT影像特征及其漏诊原因  

Analysis of CT imaging features and causes of miss diagnosis of ectopic pancreas based on endoscopy

作　　者：王宇琦 罗定豪 柴晓媛 孙鹏 马晓璇 WANG Yuqi;LUO Dinghao;CHAI Xiaoyuan;SUN Peng;MA Xiaoxuan(Department of Radiology,Air Force Medical Center,Beijing 100142,China)

机构地区：[1]空军特色医学中心,医学影像科,北京100142

出　　处：《基础医学与临床》2024年第8期1162-1164,共3页Basic and Clinical Medicine

摘　　要：目的结合内镜表现探究胃肠道异位胰腺的影像学表现,寻找漏诊原因,提高诊断准确性。方法本文收集空军特色医学中心2018年7月至2023年3月接受CT检查,经内镜及病理证实的异位胰腺患者的临床及CT影像资料,根据内镜表现分析其影像学特征,并分析其漏诊原因。结果13例异位胰腺患者,3例无明显症状,10例表现为消化道症状,包括上腹部不适疼痛、不全梗阻及黑便。病灶部位:8例位于胃窦,5例位于小肠。本组有两例患者的内镜结果显示为顶端糜烂及腺体开口样凹陷,但仅有一例患者CT上表现为“导管征”。本组13例患者影像上均未做出异位胰腺诊断,其中4例诊断为胃肠道管壁增厚,3例诊断为胃肠道间质瘤,3例诊断为良性肿瘤,3例未见明显异常。结论异位胰腺的影像诊断需密切结合内镜检查结果,提高影像诊断准确率。CT对于异位胰腺的诊断具有重要意义,胃肠道检查前充分准备是避免异位胰腺误诊、漏诊的重要步骤。Objective To explore the imaging manifestations of ectopic pancreas based on endoscopic findings in order to find out the causes of miss diagnosis and to improve the diagnostic accuracy.Methods The clinical and CT imaging data of ectopic pancreas patients who underwent CT examination and confirmed by endoscopy and pathology microscopy at Air Force Medical Center from July 2018 to March 2023 were collected.Their imaging characteristics were analyzed according to the endoscopic findings and the miss diagnosis was analyzed.Results There were 13 patients with ectopic pancreas and 3 of them had no obvious symptoms.Ten patients presented with gastrointestinal symptoms,including epigastric discomfort and pain,incomplete obstruction,and melena.Lesion sites:8 cases were located in the gastric antrum and 5 cases were located in the small intestine.In this group,two patients showed apical erosions and glandular opening-like depressions on endoscopic results,but only one patient showed a“ductal sign”shown by CT scanning.None of the 13 patients in this group made ectopic pancreatic diagnosis on imaging,of which 4 were diagnosed as thickening of the gastrointestinal tract wall,3 were diagnosed as gastrointestinal stromal tumor,3 were diagnosed as benign tumors and 3 had no obvious abnormalities.Conclusions The imaging diagnosis of ectopic pancreas should be made by closely combinating with the results of endoscopy to improve the accuracy of imaging diagnosis.CT is of great significance for the diagnosis of ectopic pancreas,and adequate preparation before gastrointestinal examination is an important step to avoid misdiagnosis.

关 键 词：胃肠道 异位胰腺 CT 消化内镜 漏诊 

分 类 号：R735[医药卫生—肿瘤]