| 施美华,李炅,邱海嵊,王静蕾,王晓霞,邵虹.儿童肠重复畸形的99TcmO4-动态平面显像、CT和超声表现[J].中国医学影像技术,2018,34(S1):22~25 |
| 儿童肠重复畸形的99TcmO4-动态平面显像、CT和超声表现 |
| 99Tcm-pertechnetate scintigraphy, CT and ultrasonographic manifestations of intestinal duplication in children |
| 投稿时间：2018-10-30 修订日期：2018-11-16 |
| DOI：10.13929/j.1003-3289.201810175 |
| 中文关键词: 肠重复畸形 儿童 体层摄影术,X线计算机 超声检查 放射性核素显像 |
| 英文关键词:Duplication of intestine Child Tomography,X-ray computed Ultrasonography Radionuclide imaging |
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| 中文摘要: |
| 目的 探讨儿童肠重复畸形的超声、CT及99TcmO4-动态平面显像表现。方法 回顾性分析18例经手术病理证实为肠重复畸形患儿的超声（n=14）、CT（n=10）及99TcmO4-动态平面显像（n=18）表现。结果 18例中2例为广泛管状肠重复畸形，15例为单发囊状或囊实性畸形，1例为双囊状重复畸形。18例中3例含异位胃黏膜，15例未见异位胃黏膜。14例行超声检查的患儿中，11例表现为形态较固定的厚壁肠管样无声团诊为肠重复畸形，1例表现为一大一小"葫芦"形两腔相通的厚壁囊性管腔结构，均正确诊断，余1例误诊、1例漏诊。CT检查可见7例均表现为厚壁囊性为主占位，与肠道关系较密切，1例诊断为其他囊性病变，2例肠管状分布畸形漏诊。99TcmO4-动态平面显像的3例均为阳性，2例表现为与小肠分布相对应的弥漫性异常放射性浓聚，均正确诊断，1例为小团状异常固定放射性浓聚灶，提示肠重复畸形可能。结论 超声、CT及99TcmO4-动态平面显像检查各有优势，超声检查因无辐射、操作简便，常作为筛查首选，CT显示解剖结构较全面，99TcmO4-动态平面显像有助于诊断临床高度怀疑肠重复畸形，尤其对于CT、超声无明确阳性表现者。 |
| 英文摘要: |
| Objective To analyze the ultrasonographic, CT and 99Tcm-pertechnetate scintigraphy manifestations of intestinal duplication in children. Methods The image characteristics of intestinal duplication by ultrasound (n=14), CT (n=10) and 99Tcm-pertechnetate scintigraphy (n=18) in 18 cases confirmed by surgery and pathology were analyzed retrospectively. Results In 18 cases, 2 cases were extensive tubular intestinal duplication, 15 cases were solitary cystic or solid-cystic intestinal duplication, 1 case was double cystic intestinal duplication, 3 cases contained heterotopic gastric mucosa while 15 cases did not. Fourteen cases underwent ultrasonography, 11 presented with a relatively fixed form of thick-walled intestinal mucosa and were diagnosed as intestinal duplication, 1 presented with a large and small "gourd-shaped" thick-walled cystic lumen, which were correctly diagnosed, and the remaining 1 case misdiagnosed and 1 missed diagnosed. Seven cases presented with thick-walled cystic space mainly in CT, which was closely related to the intestinal tract, 1 case was diagnosed as cystic mass, and 2 cases with intestinal distribution was misdiagnosis. Three case with 99Tcm-pertechnetate scintigraphy had positive results, 2 of which showed diffuse abnormal radioactive concentration corresponding to small intestine distribution and 1 was a small cluster abnormal fixed radioactive concentration, suggesting the possibility of intestinal duplication. Conclusion Ultrasonography, CT and 99TcmO4-pertechnetate scintigraphy have different advantages. Ultrasonography is often the first choice for screening because it is easy to operate and without radiation. CT shows the anatomic structures more comprehensively. 99TcmO4-pertechnetate scintigraphy is helpful to diagnose highly suspected intestinal duplication, especially for the patient who presented with hematochezia while CT and ultrasonography have no definite positive results. |
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