小儿肠重复畸形的影像学诊断

目的 提高对肠重复畸形的术前影像学认识及诊断水平。材料与方法 结合文献回顾性分析11例经手术和病理证实的肠重复畸形影像学表现、临床和病理特点。结果 11例肠重复畸形中，空肠2例，回肠8例，结肠1例，全部为囊肿型。其中，1例有细孔与回肠相通，同时有异位胃粘膜，1例囊肿穿孔，2例伴发炎症，与周围组织粘连。肠重复畸形9例位于系膜侧，2例位于系膜对侧。X线平片及钡餐见肠管受压移位，充盈钡剂的肠管勾划出肿块轮廓。超声示腹腔内囊性肿块，周围有蠕动的肠管包绕，其中1例并发感染，边缘模糊，壁厚。抗炎治疗后肿块缩小。CT扫描：低密度单房囊性肿块，壁较厚，增强扫描囊壁可强化。推移囊肿后位置可发生一定变化。结论 通过对多种影像学检查的综合分析并紧密结合临床，可提高肠重复畸形的术前诊断水平。

Imaging Diagnosis of Intestinal Duplications in Children

Objective To make a further understanding of the imaging manifestations of the intestinal duplications in children.Materials and Methods The imaging features, clinical data and pathological results of 11 cases with surgically and pathologically confirmed intestinal duplications were retrospectively analyzed.Results Of 11 cases, the duplication occurred in jejunum in 2, in ileum in 8 and in colon in one. All the cases were cystic type. In one case the lesion was communicated with ileum through a small pore and carried ectopic gastric mucosa. Perforation was seen in one case, and inflammation with adhesion to adjacent structures in 2 cases. The duplication was located at mesenteric side in 9 cases and at opposite mesenteric side in 2 cases. On plain film and barium meal exam, intestinal displacement due to compression and outlined mass by barium filled intestine could be seen. On ultrasonograph, cystic mass with peristaltic loop around was seen. Infection was found in one case, the lesion was thick walled and showed a vague margin. The mass size decreased after therapy. On CT scan, the lesion presented as a thick walled, low density, unilocular cyst, the cystic wall showed enhancement after contrast injection.Conclusion By a close combination of varied imaging methods with clinical data, preoperative diagnosis of intestinal duplication can be improved.