十二指肠疾病的MSCT诊断

目的:评价多层螺旋CT(MSCT)及其后处理技术对十二指肠病变的诊断价值。方法:搜集11例十二指肠病变患者资料,患者均为男性,年龄29~65岁,平均47岁。MSCT检查采用GELightspeed16CT,扫描前口服500ml水,均行平扫及增强扫描,后者包括周围静脉法和导管法两种,分别经肘前静脉注射及肠系膜上动脉插管注射非离子型对比剂,对比剂的量分别为80ml及40ml,注射流率均为3ml/s,动脉期及静脉期延迟时间分别为30s、60s及2s、32s。层厚10mm,螺距1.375∶1。10例增强后图像进行1.25mm薄层重建后传入工作站进行后处理,MSCT后处理技术包括多平面重组(MPR)及最大密度投影(MIP)。结果:MSCT诊断球部溃疡出血2例,球部穿孔2例,乳头部肿瘤1例,横部肿瘤1例,横部结核1例,横部旋转不良1例,降部憩室1例,胰腺癌侵犯降部1例,假阴性1例。其中2例经DSA及手术证实,6例经手术证实,1例经内镜证实,1例既往有胰腺癌病史,失去手术指征。另外MSCT诊断正常1例,剖腹探察术中发现十二指肠乳头部一小肿瘤,病理诊断为类癌。结论:MSCT结合后处理技术能有效评价十二指肠病变。

MSCT Diagnosis of the Duodenal Diseases

Objectives:To evaluate the value of MSCT and post-processing techniques in the diagnosis of duodenal disorders.Methods:From January through April 2005,11 consecutive patients (11 men;age range,29~65 years;mean age,47 years) were scheduled to undergo abdominal MSCT with a MSCT scanner (GE Lightspeed 16 CT) with a slice-thickness of 10mm before and after contrast material was administered with a power injector.500ml water was administrated orally before scanning.Contrasted material was injected via peripherial vein (9 cases) or superior mesenterial artery (2 cases) with a total volume of 80ml or 40ml respectively,with a injection rate of 3ml/s,the scan delay were 30s,60s (for intravenous injection) and 2s,32s (for intra-arterial injection) for arterial and venous phase respectively.Source images were recon- structed into images with slice-thickness of 1.25mm and were transferred a workstation with which post-processing was conducted.The post-processing included multiple planar reconstruction (MPR) and maximal intensity projection (MIP).Results:Of the 11 patients,MSCT found ulcer complicating hemorrhage in 2,perforations in 2,tumors in 2,tuberculosis in 1, diverticulum in 1,malrotation in 1,and invasion of pancreatic carcinoma in 1.MSCT missed 1 case of small tumor in the papilla of duodenum which was found surgically.Conclusion:MSCT and post-processing techniques is helpful in demonstrating duodenal disorders.