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目的探讨多排螺旋CT(MDCT)对肠息肉的显示情况及良恶性诊断正确性。资料与方法经病理证实的33例(按解剖部位共54例)肠息肉患者均行内镜及MDCT平扫和双期增强扫描,回顾性分析并比较两种检查对不同部位肠息肉的检出情况和MDCT对肠息肉良恶性的诊断情况。结果 MDCT共检出肠息肉54例,其中小肠3例(均位于空肠),结肠38例(升结肠回盲部6例,横结肠4例,降结肠9例,乙状结肠19例),直肠13例。CT拟诊良性46例,恶性8例,病理证实5例恶变,恶性诊断正确率为62.5%(5/8)。内镜共检出48例,3例胃癌术后吻合口远端空肠小息肉均漏诊,1例回盲部小息肉、2例直肠远端小息肉均漏诊。结论 MDCT多平面重组图像结合双期增强薄层轴位图像能准确检出不同解剖部位的肠息肉,对肠息肉的检出优于内镜;对预测息肉有无恶变及随访复查有重要的临床价值。
Objective To investigate the display of intestinal polyps by multi-slice spiral CT (MDCT) and the correctness of benign and malignant diagnosis. Materials and Methods 33 patients with intestinal polyps confirmed by pathology (54 anatomical sites) underwent endoscopic and MDCT plain scans and double-phase enhanced scanning. The detection of intestinal polyp in different sites was retrospectively analyzed and compared Cases and MDCT of benign and malignant intestinal polyps diagnosis. Results There were 54 cases of intestinal polyps detected in MDCT, including 3 cases of small intestine (all located in the jejunum), 38 cases of colon (6 cases of ascending ileocecal region, 4 cases of transverse colon, 9 cases of descending colon and 19 cases of sigmoid colon) and 13 cases of rectum. Forty-six cases were diagnosed as benign and malignant by CT, and 5 cases were confirmed by pathology. The correct rate of malignant diagnosis was 62.5% (5/8). Endoscopy were detected in 48 cases, 3 cases of gastric cancer distal jejunal small polyps after anastomotic leakage were missed, 1 case of ileocecal polyps, 2 cases of distal rectal polyps were missed. Conclusions MDCT combined with two-phase enhanced axial slice imaging can accurately detect intestinal polyps in different anatomical sites and is superior to endoscopy in the detection of intestinal polyps. It is an important clinical tool for predicting malignancy and follow-up of polyps value.