多层螺旋CT对十二指肠憩室的诊断价值

目的：探讨多层螺旋CT（MSCT）在十二指肠憩室（DD）诊断中的临床应用价值。方法：回顾性分析26例（28个憩室）经上消化道钡餐、胃十二指肠镜或ERCP检查证实的十二指肠憩室患者的CT表现及临床资料,所有病例均采用多层螺旋CT容积扫描,行轴位、冠状及矢状位多平面重建（MPR）图像,同时结合局部薄层图像进行观察。结果：憩室位于十二指肠降段22个,水平段4个,升部2个;直径1.0～5.0 cm者24个,大于5.0 cm者2个,小于1.0 cm者2个;CT表现为十二指肠壁外的圆形、椭圆形囊袋状影,囊内为气-液平或气液-食物混杂密度影25个,囊内仅为气体或液体密度影3个;单纯合并胆囊结石3例,胆总管结石1例,急性胆囊炎3例,胰腺炎2例。结论：多层螺旋CT能很好地显示十二指肠憩室及相关的胆胰并发症,具有一定的临床应用价值。

The Value of Multi-slice Spiral CT in Detecting Duodenal Diverticula

Objective：To investigate the clinical value of multi-slice spiral CT in detecting duodenal diverticula. Method：The CT manifestation and clinical data of 26 cases with 28 duodenal diverticula confirmed by the upper gastrointestinal barium meal, gastroduodenoscope or endoscopic retrograde cholangio-pancreatography （ERCP） examination were retrospectively analyzed. All the cases received the volume scanning of multi-slice spiral CT to get the multi-planar reformation（MPR） images from axial, coronal and sagittal position and the local thin slice images. Result：All the 28 duodenal diverticula, 22 were located at the descending duodenum, 4 at the horizontal, 2 at the ascending, and 24 were with the diameter of 1.0-5.0 cm, 2 more than 5.0 cm and 2 less than 1.0 cm. The CT demonstrated the circular or elliptical cystic shadow outside of the duodenal wall, with 25 gas-liquid level or mixture of gas, liquid and food density zone and 3 only gas or liquid density zone inside the cyst. 3 cases were complicated by cholecystolithiasis, 1 by choledocholithiasis, 3 by acute cholecystitis, and 2 by pancreatitis.Conclusion：Multi-slice spiral CT is quite well for detecting duodenal diverticula and relevant biliary and pancreatic complications, thereby of definite clinical value.