胃憩室的MSCT诊断及误诊分析

目的 探讨胃憩室的MSCT表现及其误诊原因.方法 回顾性分析经手术病理、胃镜和钡餐检查联合证实的11例胃憩室患者的临床和影像资料,观察胃憩室的部位、密度、大小,对其MSCT诊断结果和误诊原因进行探讨.结果 胃憩室的发生部位：胃窦小弯侧1例,胃底10例,后者又包括左侧肾上腺区3例,胰腺尾部1例,靠近贲门2例,胃底大弯侧3例,胃底小弯侧1例.胃憩室的密度：囊性密度3例,液气囊1例,内容物密度6例,另1例做了多种对比剂检查,既有高密度混杂对比剂密度,又有液气囊密度.胃憩室的大小：6例在1～2 cm之间,长径大于2cm者3例,短径小于1cm者2例.11例胃憩室的MSCT诊断中,误诊左侧肾上腺肿瘤2例;误诊胰腺占位1例;漏诊和提示诊断各4例.结论 提高有关胃憩室相关知识的认识,有助于MSCT对其做出正确诊断.

Multi-slice spiral computed tomography diagnosis and misdiagnosis of gastric diverticulum

Objective To investigate multi-slice spiral computed tomography （MSCT） performance and misdiagnosis of gastric diverticulum. Methods Clinical materials and imaging findings of 11 patients with gastric diverticulum confirmed by pathology, endoscopy and barium meal examination were retrospectively analyzed. The site, density and size of gastric diverticulum were observed, then its MSCT diagnosis and misdiagnosis was discussed. Results The site of gastric diver- ticulum： one case was located on antral lesser curvature, the other 10 cases were located on gastric fundus, including 3 ca- ses near the left adrenal gland, one case near the tail of the pancreas, 2 cases near the cardia, 3cases near greater curvature and one case near lesser curvature. The density of gastric diverticulum： 3 cases of cystic density, one case of liquid-gas level, 6 cases of gastric contents density, and another one case menifested as both mixed high-density contrast and liquid- gas level after a variety of contrast agent examination. The size of gastric diverticulum： the greater diameter more than 2 cm in 3 cases, the shorter diameter less than 1 cm in 2 cases, and the diameters between 1-2 cm in 6 cases. MSCT diag- nosis of gastric diverticulum：two cases were misdiagnosed as left adrenal tumor, one case was misdiagnosed as pancreatic cyst, missed and prompt diagnosis were respectively 4 cases. Conclusion It is useful to raise the awareness of relevant knowledge about gastric divert＇iculum for its correct diagnosis with MSCT.