徐莉,梁长虹,刘再毅,崔燕海,刘辉,李景雷.原发性十二指肠腺癌多层螺旋CT表现[J].中国医学影像技术,2009,25(4):650~652
原发性十二指肠腺癌多层螺旋CT表现
MSCT features of primary duodenal adenocarcinoma
投稿时间:2008-10-22  修订日期:2008-12-03
DOI:
中文关键词:  十二指肠肿瘤  腺癌  体层摄影术,X线计算机
英文关键词:Duodenal neoplasms  Adenocarcinoma  Tomography, X-ray computed
基金项目:
作者单位E-mail
徐莉 广东省人民医院放射科,广东 广州 510080  
梁长虹 广东省人民医院放射科,广东 广州 510080 cjr.lchh@vip.163.com 
刘再毅 广东省人民医院放射科,广东 广州 510080  
崔燕海 广东省人民医院放射科,广东 广州 510080  
刘辉 广东省人民医院放射科,广东 广州 510080  
李景雷 广东省人民医院放射科,广东 广州 510080  
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中文摘要:
       目的 观察多层螺旋CT(MSCT)三期增强扫描及多平面重建对原发性十二指肠腺癌诊断价值。方法 回顾性分析21例经病理证实的十二指肠腺癌患者的MSCT影像。结果 ①14例表现为局部息肉状或菜花状软组织肿块;6例表现为肠壁不规则或环形增厚,肠腔狭窄;②CT平扫、肝动脉相和门静脉相CT值分别为39 HU、63 HU、74 HU;③肝内外胆管扩张14例,伴近段肠管扩张5例,2例可见小肠内容物征,肠壁缺血及水肿2例,肠壁坏死1例,肠套叠1例;胰腺侵犯4例;腹腔及腹膜后淋巴结肿大4例;腹水2例;肝转移的5例门脉期均较动脉期显示病灶更清楚;肋骨转移1例;系膜及网膜受累3例;血管受侵2例。多平面冠状位重建清晰显示十二指肠水平部的肿瘤与周围结构、血管的关系。结论 ①MSCT能很好地显示十二指肠腺癌直接征象及伴随征象。十二指肠腺癌淋巴结转移多以小淋巴结为主。②多平面冠状位重建能较好显示十二指肠水平部的肿瘤以及与周围胰腺、主动脉及肠系膜血管的关系。
英文摘要:
      Objective To observe the features of duodenal adenocarcinoma on multislice spiral CT (MSCT). Methods In 21 patients with duodenal adenocarcinoma verified by pathology, the features on MSCT were retrospectively analyzed. Results ①Small polypoid or cauliflower-like lesion with soft tissue density was found in 14 patients,while duodenal wall thickening and luminal narrowing were shown in 6 patients. ②CT values of lesions were 39 HU (plain scan), 63 HU (hepatic arterial phase), 74 HU (portal vein phase) and 70 HU (delayed phase). ③Other findings included intrahepatic and extrahepatic bile duct dilatation in 14 patients, approaching intestinal canal expansion in 5 patients, small-bowel feces sign in 2 patients, intestine wall ischemia and oedema in 2 patients, intestine wall necrosis in 1 patient, intussusceptions in 1 patient, abdominal cavity and retroperitoneal lymph node enlargement in 4 patients, pancreatic gland encroachment in 4 patients, ascites in 2 patients, rib metastasis in 1 patient, mesenterium and retina encroachment in 3 patients, vessel encroachment in 2 patients. Conclusion ①Duodenal adenocarcinoma can be commendably demonstrated with MSCT. Dilatation of intrahepatic bile duct and the hepatic metastasis can be depicted well on the portal vein phase. ②Images in the coronal plane are especially helpful to display tumors in the third portion of the duodenum and the relation to the pancreas, aorta and mesenteric vessels.
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