原发性小肠恶性肿瘤消化道钡餐与CT对照分析

目的：评价各种成像技术（传统消化道钡餐、CT、血管造影）诊断原发性小肠恶性肿瘤的价值，提高对小肠恶性肿瘤的认识。材料与方法：回顾性分析了43例经手术证实的原发性小肠恶性肿瘤影像资料。结果：病变包括腺癌17例，平滑肌肉瘤6例，淋巴瘤20例。消化道钡餐主要X线表现为胸腔狭窄，肠腔内充盈缺损，管壁僵硬，粘膜破坏，环状皱壁消失，肠梗阻或肠套叠，肠管扩张及溃疡形成。CT检查11例，均确诊为小肠恶性肿瘤。血管造影2例，均拟诊为小肠血管畸形。结论：凡临床疑有小肠恶性肿瘤通常首选胃肠造影法，若诊断不明或为手术前进一步明确病变的范围宜用CT检查，对不明原因反复发生的上消化道出血血管造影具有重要价值。

Comparative Analysis of Gastrointestinal Meal Barium and CT for Primary Malignant Tumors of the Small Bowel

Purpose: To assess the value of all kinds of imaging techniques (including gastrointestinal meal barium, CT and angiography) and to heighten the awareness of primary malignant tumors of the small bowel. Materials and methods: Imaging findings in 43 cases of primary malignant tumors of the small bowel proved by operation were analysed retrospectively. Results:The lesions included 17 cases of adenocarcinomas, 6 cases of leiomyosarcomas and 20 cases of lymphomas. The main X-ray manifestations of gastrointestinal meal barium of primary malignant tumors of the small bowel were stenosis, filling defect, stiffness of involved intestinal wall with destruction of mucosa and loss of valvulae conniventes,intestinal obstruction or intussuseption,dynamic dilatation and ulcer. Eleven cases were confirmed the diagnosis of primary malignant tumors of small bowel by CT and two cases were preliminarily diagnosed as the vascular abnormality of small intestine by angiography. Conclusion: Gastrointestinal meal barium should be firstly selected in all clinically suspected malignant tumors of small intestine. If the lesion is not identified by the meal barium or the range of the lesion should be further determined preoperatively, CT may be used. Furthermore, gastrointestinal angiography is very valuable in diagnosis of repeated hemorrhage of unknown origin in the upper digestive tract.