小肠腺癌的螺旋CT诊断

目的评价螺旋CT在小肠腺癌诊断和鉴别诊断中的价值。方法对23例经病理证实的小肠腺癌的影像表现进行回顾性分析。结果23例小肠腺癌发生在十二指肠11例，空肠7例，回肠5例。14例表现为局部结节样或菜花状软组织肿块；9例表现为肠壁不规则或环形增厚，肠腔狭窄；其它表现包括：侵犯肝门、壶腹部合并胆道梗阻8例，不完全性肠梗阻7例，腹腔及腹膜后淋巴结肿大6例，周围结构侵犯与转移18例，腹水征6例，1例病灶合并肠套叠。增强扫描动脉期呈较明显强化（CT值平均增加45Hu），门脉期及延迟期强化不明显（CT值平均增加23Hu）。结论掌握小肠腺癌的CT表现的特征有助于与小肠问质瘤、淋巴瘤与类癌的鉴别；多平面重建有助于显示病变与周围结构的关系及远处转移的情况。

CT features of Small Bowel Adenocarcinoma

Objective To analyze the findings of small bowel adenocarcinoma on spiral CT. Methods In 23 patients with small bowel adenocarcinoma verified by histopathology, the findings on MSCT were retrospectively analyzed. Results Lesions in 11 cases were located in duodenum, 7 in jejunum and 5 in ileum. A small polypoid or cauliflower - like lesion with soft tissue density was found in 14 cases ; Duodenal wall thickening and luminal narrowing were shown in 9 cases. CT values of lesions were increased 45 Hu（ hepatic arterial phase） ,and 23Hu（ portal vein phase and delayed phase）. Other findings include： intrahepatic and extrahepatie bile duct ilatation in 8 pa- tients, approaching intestinal canal expansion in 7 patients, abdominal cavity and retroperitoneal lymph node enlargement in 6 patients, surrounding structure encroachment and metastasis in 18 patients and intussuseeption in 1 patient. Conclusion The lesion of small bowel adencarcinoma could be commendably demonstrated, and hence be helpful to differential diagnosis of other small bowel tumors. Images in multiplanar reconstruction are especially helpful to display tumors and their relation to the pancreas, aorta, and mesenterie vessels.