可切除原发性十二指肠恶性肿瘤X线征象分析

目的 :对可切除的原发性十二指肠恶性肿瘤X线征象进行分析。方法 :对 2 6例原发性十二指肠恶性肿瘤胃肠道造影及CT征象进行了回顾性对比分析总结。结果 :全部病例均经手术病理证实 ,其中腺癌 2 2例 ,平滑肌肉瘤 3例 ,非何杰金氏淋巴瘤 1例。描述包括肿瘤的部位 ,造影X线表现 (黏膜破坏 ,充盈缺损及龛影 ,管腔不规则狭窄 ,肠腔外改变等 )及CT表现 (肠壁增厚肠腔狭窄 ,局部肿块 ,梗阻性改变及转移 )。不能手术切除的影像学征象为 :肿瘤直径大于 6cm ;腹腔、系膜淋巴结成团肿大 ;腔静脉、肠系膜动静脉等重要血管管径被包绕大于 2 / 3时。结论 :CT与X线造影对肿瘤的位置、大小、形态 ,肿瘤的继发征象的术前评价 ,能够提供能否手术切除的重要依据。

RADIOGAPHIC FEATURES OF RESECTABLE PRIMARY DUODENAL MALIGNANCES

Objective:Purpose To evaluate the Radiographic and CT features of resectable primary duodenal malignances.Method:Radiographic and CT appearance of 26 patiems with primary malignant duodenal neoplasm was compared and analyzed retrospectively.Result:In all these pathologically confirmed cases, 22 was adenocarcinoma, 3 was leiomyosarcoma, and also with one non Hodgldn's lymphoma. Radiographic observation focused on the destruction of the mucous, filling defect, ulceration, intraluminal irregular narrowing and extraluminal features. CT studies focused on thickening and stenosis of the duodenum wall, local mass extension, obstruction of the bowel and tumor metastatic features. The unresectable sign of the local malignancies includes: local mass with a diameter more than 6cm; Periportal or perimesenteric lymphadenopathy; More than two-third invation of vital structures such as SMA, IVC, etc. Conclusion:Radiographic features and CT findings,such as location, size, morphology, as well as secondary changes due to the tumor can provide the detailed preoperative information about the local malignancies.