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目的:探讨256层多排螺旋CT小肠成像(MDCTE)扫描技术在小肠肿瘤性疾病诊断中的应用价值。方法:对118例临床疑似小肠疾病患者行256层MDCTE平扫及增强扫描,通过横断面及多平面重建,观察病变部位、大小、形态、周围侵犯及转移情况,结果与最终病理诊断进行对照分析。结果:本研究的118例患者中,小肠肿瘤15例,其中腺癌5例,误诊2例(2/15),影像表现为肠壁不规则增厚或分叶状肿块,近端肠道梗阻;间质瘤3例,表现为富血供肿块而无肠道梗阻;淋巴瘤1例,表现为小肠壁较长节段的不均匀增厚,肠腔反而扩张,病灶强化不明显;空肠平滑肌瘤1例,误诊为腺瘤(1/15),表现为肠壁不规则增厚,动静脉期强化不明显;肠系膜转移5例,漏诊2例(2/15),表现为肠系膜密度增高、腹腔内多发淋巴结肿大、腹水形成等。结论:小肠肿瘤性病变在MDCTE图像上具有特征性表现,MDCTE能全景式、多方位展示小肠肠道、肠系膜和系膜血管,对小肠肿瘤的诊断具有重要价值。
Objective: To investigate the value of 256-slice multi-slice spiral CT small bowel imaging (MDCTE) in the diagnosis of small intestine neoplastic diseases. Methods: A total of 118 patients with suspected small intestinal diseases underwent plain MDCT scan and enhanced scan. The cross-sectional and multiplanar reconstruction were performed to observe the location, size, shape, surrounding invasion and metastasis. The results were compared with the final pathological diagnosis . Results: Of the 118 patients in this study, 15 cases of small intestine tumors, including 5 cases of adenocarcinoma, 2 cases of misdiagnosis (2/15), the image showed irregular thickening of the intestinal wall or lobulated mass, proximal intestinal obstruction ; Stromal tumor in 3 cases, manifested as blood-rich mass without intestinal obstruction; lymphoma in 1 case, showed a long segment of the small intestine wall of non-uniform thickening, but instead of the expansion of the intestine, focal enhancement was not obvious; jejunal smooth 1 case of myoma, misdiagnosed as adenoma (1/15), showed irregular thickening of the intestinal wall, arteriovenous phase enhancement was not obvious; mesenteric metastasis in 5 cases, missed diagnosis in 2 cases (2/15), showed increased mesenteric density , Multiple intra-abdominal lymph nodes, ascites formation. Conclusions: The small intestine neoplastic lesions have characteristic features in MDCTE images. MDCTE can display the intestine, mesentery and mesangial vessels of the small intestine panoramicly and multi-azimuthally, which is of great value in the diagnosis of small intestinal tumors.