十二指肠管状绒毛状腺瘤的CT表现

目的探讨十二指肠管状绒毛状腺瘤的CT表现。方法回顾性分析经病理证实的12例管状绒毛状腺瘤（2例伴局灶癌变）的临床和CT资料。男性8例、女性4例;年龄59-76岁,中位年龄61.5岁。结果本组12例均发生于十二指肠降部,为局部结节或软组织肿块,最大径8-37 mm,平均（17.5±8.8）mm,2例伴局灶癌变者最大径分别为37和18 mm。10例边界清晰、2例边界欠清。12例均无浆膜面累及,周围无明显肿大淋巴结。平扫密度均匀,增强后11例中度强化、1例伴局灶癌变病例呈较高程度强化。6例伴胆管系统扩张（5例轻度、1例中度）,其中4例同时伴胰管扩张。结论十二指肠管状绒毛状腺瘤好发于十二指肠降部,多表现为边界清楚、中度强化结节影,邻近乳头区可引起胆管轻度梗阻,瘤体大或强化明显者提示恶变可能。

CT findings of duodenal villous tubular adenoma

Objective To investigate the CT findings of duodenal villous tubular adenoma.Methods CT and clinical data of 12 patients with pathologically proven duodenal villous tubular adenoma （2 cases were companied with focal cancerous tissue） were retrospectively analyzed. The cases were composed of 8 men and 4 women, with a median age of 61.5 years （rang 59-76）.Results All lesions were shown as soft nodules located in the descending part of duodenum. The maximum diameter of 12 lesions was 8-37 mm, averaged at （17.5±8.8） mm. The maximum diameters in the 2 cases with focal cancerous tissue were 37 mm and 18 mm, respectively. Ten lesions were well-defined and 2 had ill-defined margins. Duodenal serosa invasion or enlarged lymph nodes were not observed in all cases. After intravenous injection of contrast media, 11 lesions displayed moderate enhancement, and one lesion showed obvious enhancement. Biliary duct dilation was detected in 6 cases （5 slight and 1 moderate）, and pancreatic duct dilation was observed in 4 of them simultaneously.Conclusion Duodenal villous tubular adenoma usually manifests well-defined nodules with moderate enhancement located in the descending duodenum. Nodules close to duodenal papillary region may lead to biliary obstructive, and large nodules with obvious enhancement suggest the possibility of canceration.