儿童胃重复畸形的影像学表现

目的 分析儿童胃重复畸形的临床表现、影像特征及鉴别诊断要点，提高对该病的认识和影像学诊断水平。方法 回顾性分析5例经手术病理证实的儿童胃重复畸形的临床及影像学表现。采用CT及MRI观察病变的数量、位置、形态、密度或信号特点、与胃壁的关系、病变周围情况及强化特点等；上胃肠道造影动态观察胃肠道形态、走行、肠管蠕动、管腔充盈情况和对比剂通过情况，以及是否存在梗阻及充盈缺损等异常征象。结果 2例无症状者于平扫CT和MRI上表现为与邻近胃壁紧密连接的单发类圆形囊性肿物，囊壁较薄，边界清晰；3例有症状者平扫CT显示病变囊壁增厚，边界不清，所有病变囊壁均未见钙化。5例CT增强检查均显示囊壁强化而囊内无强化；上胃肠道造影显示，腔内型病变表现为胃窦部巨大充盈缺损并胃出口梗阻，腔外型病变对胃壁形成了外压性切迹。结论儿童胃重复畸形是临床少见的胃肠道先天性畸形，临床表现多变且特异性较差，影像学表现具有一定特征，术前全面的影像学检查有助于临床诊断和治疗。

The imaging manifestations of gastric duplication cysts in children

Objective To explore the clinical and imaging manifestations, and key points of differential diagnosis of gastric duplication cysts in children so as to improve the recognition and diagnosis of gastric duplication cysts. Methods The clinical and imaging findings of five children with gastric duplication cysts that confirmed by surgery and pathology were analyzed retrospectively.The number, location, shape, density or signal characteristics of the lesions, the relationship with the gastric wall, surrounding conditions, and enhancement characteristics of the lesions were observed on CT and MRI. The gastrointestinal morphology, course and distribution, intestinal peristalsis, lumen filling, contrast medium passage, and probable abnormal signs such as obstruction and filling defects were dynamically observed on the fluoroscopic upper gastrointestinal series. Results The gastric duplication cysts of two asymptomatic cases presented as a solitary rounded mass with cyst-like signal or density that closely related to gastric wall on non-contrast CT and MRI. The cyst wall was thin with clear boundary. Thickened cyst wall with obscure boundary were found in three symptomatic cases on non-contrast CT. No calcification was found in any cases. The cyst walls were significant enhancement without enhancement inside the cyst after administration of contras tagent in all five cases. Upper gastrointestinal contrast examination showed agiant filling defect in antrum and gastric outlet obstruction in intraluminal type and just acompressional incisure in extraluminal type. Conclusion Gastric duplication cyst is a rare condition of intestinal congenital malformation with variable and nonspecific clinical findings. The imaging findings have certain characteristics, and comprehensive imaging examination before operation is helpful for clinical diagnosis and treatment.