摘要
目的观察多层螺旋CT(MSCT)三期增强扫描及多平面重建对原发性十二指肠腺癌诊断价值。方法回顾性分析21例经病理证实的十二指肠腺癌患者的MSCT影像。结果①14例表现为局部息肉状或菜花状软组织肿块;6例表现为肠壁不规则或环形增厚,肠腔狭窄;②CT平扫、肝动脉相和门静脉相CT值分别为39HU、63HU、74HU;③肝内外胆管扩张14例,伴近段肠管扩张5例,2例可见小肠内容物征,肠壁缺血及水肿2例,肠壁坏死1例,肠套叠1例;胰腺侵犯4例;腹腔及腹膜后淋巴结肿大4例;腹水2例;肝转移的5例门脉期均较动脉期显示病灶更清楚;肋骨转移1例;系膜及网膜受累3例;血管受侵2例。多平面冠状位重建清晰显示十二指肠水平部的肿瘤与周围结构、血管的关系。结论①MSCT能很好地显示十二指肠腺癌直接征象及伴随征象。十二指肠腺癌淋巴结转移多以小淋巴结为主。②多平面冠状位重建能较好显示十二指肠水平部的肿瘤以及与周围胰腺、主动脉及肠系膜血管的关系。
Objective To observe the features of duodenal adenocarcinoma on multislice spiral CT （MSCT）. Methods In 21 patients with duodenal adenocarcinorna verified by pathology, the features on MSCT were retrospectively analyzed. Resuits ①Small polypoid or cauliflower like lesion with soft tissue density was found in 14 patients,while duodenal wall thickening and luminal narrowing were shown in 6 patients.②CT values of lesions were 39 HU （plain scan）, 63 HU （hepatic at-terial phase）, 74 HU （portal vein phase） and 70 HU （delayed phase）.③Other findings included intrahepatic and extrahepatic bile duct dilatation in 14 patients, approaching intestinal canal expansion in 5 patients, small-bowel feces sign in 2 patients, intestine wall ischemia and oedema in 2 patients, intestine wall necrosis in 1 patient, intussuseeptions in 1 patient, abdominal cavity and retroperitoneal lymph node enlargement in 4 patients, pancreatic gland encroachment in 4 patients, ascites in 2 patients, rib metastasis in 1 patient, mesenterium and retina encroachment in 3 patients, vessel encroachment in 2 patients. Conclusion ①Duodenal adenocarcinoma can be commendably demonstrated with MSCT. Dilatation of intrahepatic bile duct and the hepatic metastasis can be depicted well on the portal vein phase. ②lmages in the coronal plane are especially helpful to display tumors in the third portion of the duodenum and the relation to the pancreas, aorta and mesenteric vessels.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第4期650-652,共3页
Chinese Journal of Medical Imaging Technology
