小肠肿瘤的影像学诊断

目的探讨小肠肿瘤的影像学表现及其病理学基础。方法搜集经手术病理证实的小肠肿瘤患者17例进行回顾分析。17例均行全消化道造影和螺旋CT平扫和双期增强扫描,7例行内镜检查。结果低分化腺癌3例,鳞腺癌1例,恶性间质瘤13例。发生于十二指肠7例,空肠6例,回肠4例。钡餐造影主要表现为黏膜变平或破坏12例,管腔狭窄5例。CT表现为不规则肿块,瘤体较大,瘤体内有低密度坏死区和细小钙化灶,双期增强扫描,肿块均有明显的不均匀强化,周围组织和淋巴结受侵。结论对临床疑为原发性小肠肿瘤者应首选上消化道造影,CT是明确诊断的主要影像检查技术,并对指导临床治疗和估计预后有一定的价值。

Imaging Diagnosis of Small Bowel Neoplasm

Objective To evaluate the imaging characters and pathologic findings of small bowel neoplasm.Methods 17 patients with small bowel neoplasm proved surgically and pathologically were collected and retrospectively analyzed. Gastrointestinal barium study and plain and enhanced CT were performed in all cases,while additional endoscopy was done in 7 cases.Results There were poorly differentiated adenocarcinoma in 3 cases,squamo-adenocarcinoma in 1 case and malignant interstitial tumors in 13 cases.On barium radiographs,flattened and destruction of the mucous in 12 cases and partial lumen stenosis in 5 cases were seen.On CT scans,the lesions appeared as irregular masses with necrosis and calcification,there were markely inhomogeneous enhancement,and the adjacent tissues and lymph were involved.Conclusion For the patients suspected small bowel neoplasm ,gastrointestinal barium meal examination should be performed first.CT is the main imaging technique in confirming the diagnosis,and is of certain value in guiding the clinical treatment and estimating prognosis.