多层螺旋CT诊断十二指肠肿瘤的临床价值分析

目的 探讨多层螺旋CT（MSCT）与病理对照对十二指肠肿瘤诊断价值。方法 对79例经病理证实的十二指肠肿瘤MSCT资料及发病机制进行回顾性分析。结果 79例原发性十二指肠肿瘤中十二指肠腺癌57例,间质瘤7例,恶性淋巴瘤7例,类癌4例,脂肪瘤2例,腺瘤2例。十二指肠腺癌CT表现为十二指肠局部软组织肿块影,伴肠腔不规则狭窄;间质瘤CT表现多为较大软组织肿块,有明显强化,肿块多腔外生长;恶性淋巴瘤CT表现肿瘤累及肠管范围较长,肠壁增厚明显,呈轻-中度强化,但肠梗阻症状不明显;类癌CT表现软组织肿块或结节影,强化较明显;脂肪瘤CT表现边界清楚的低密度肿块影（CT值为负值）,强化不明显;腺瘤CT表现等密度的菜花状小肿块影,增强扫描明显均匀强化,边缘有分叶状。结论 MSCT有助于十二指肠肿瘤的定位,定性诊断,对临床制定治疗方案和预后的评估有很大帮助。

Analysis of the clinical value of MSCT in the diagnosis of duodenal tumor

Objective To explore the clinical value of multislice spiral CT （MSCT）, together with pathological examination, in the diagnosis and differential diagnosis of duodenal tumor. Methods The MSCT data and pathogenesis of 79 patients with duodenal tumor confirmed by pathology were retrospectively analyzed. Results Of these 79 patients with primary duodenal tumor, 57 were duodenal adenocarcinoma, 7 were stromal tumor, 7 were malignant lymphoma, 4 were carcinoid tumor, 2 were lipoma, and 2 were adenoma. CT manifestations of adenocarcinoma of the duodenum were the soft tissue shadow, with irregular stenosis of intestinal cavity. CT manifestations of stromal tumor were a large soft tissue mass, which was obviously enhanced and grew outside the cavity. CT findings of malignant lymphoma were that the tumors involved intestines in a longer range and the bowel wall obviously become thickening, which were shown mild or moderate enhancement, but, intestinal obstruction symptoms were not obvious. CT on carcinoid tumor showed a soft tissue mass or nodule, which was enhanced obviously. CT on lipoma showed a low density mass with clear boundary （CT was negative）, which was not obviously enhanced. As for the adenoma, CT manifestations were a small mass like cauliflower, which presented with equidensity, homogeneous enhancement, and the lobulated edge. Conclusion MSCT is helpful for the position and qualitative diagnosis of duodenal tumor, which is of great importance for assessing the treatment plan and prognosis.