小肠肠壁增厚的多层螺旋CT小肠造影征象分析和诊断价值

发布时间：2018-04-17 03:04

本文选题：CT小肠造影 + 克隆病　；参考：《临床放射学杂志》2015年12期

【摘要】：目的探讨小肠肠壁增厚的MSCT小肠造影(MSCTE)征象在不同类型小肠疾病诊断中的价值。方法搜集MSCTE发现小肠壁增厚并经手术、病理或临床证实为小肠肿瘤、小肠梗阻、小肠炎性或感染性疾病、低蛋白血症和小肠扩张症的患者共32例,由两名有经验的放射科医师共同阅片,分析增厚肠壁的受累肠段、受累长度、对称与否、强化方式、程度以及肠周异常在不同类型疾病中出现的情况。结果肠壁增厚累及十二指肠2例,空肠近段7例,空肠远段4例,回肠近段1例,回肠远段14例,弥漫性4例。不均匀强化和不对称性的局限性肠壁增厚多见于小肠腺癌、间质瘤和转移瘤,均匀强化和对称性的节段性肠壁增厚多见于炎性或感染性疾病、小肠梗阻。节段性或弥漫性肠壁增厚除淋巴瘤外,主要见于良性病变,增厚肠壁分层状强化多见于炎性或感染性疾病,强化减弱多见于肠缺血,均匀强化和不均匀强化多见于肿瘤;增厚肠壁邻近淋巴结增大多见于小肠恶性肿瘤、Crohn氏病和结核,邻近肠系膜血管异常多见于小肠梗阻、炎性或感染性疾病。结论小肠肠壁增厚的长度、对称性、强化方式及肠周异常的不同有助于小肠肿瘤、小肠梗阻、小肠炎性或感染性疾病的诊断和鉴别诊断。
[Abstract]:Objective to investigate the value of MSCT small intestinal angiography (MSCT) in the diagnosis of different types of small bowel diseases.Methods 32 patients with small bowel wall thickening and confirmed by operation, pathology or clinical diagnosis by MSCTE were selected as small intestinal tumor, small bowel obstruction, enteritis or infectious disease, hypoproteinemia and small intestinal dilatation.Two experienced radiologists read the films together to analyze the involved segments of the thickened intestine wall, the length of the involved intestine, the symmetry or not, the enhancement mode, the degree and the appearance of the abnormal intestine in different types of diseases.Results intestinal wall thickening involved duodenum in 2 cases, proximal jejunum in 7 cases, distal jejunum in 4 cases, proximal ileum in 1 case, distal ileum in 14 cases and diffuse in 4 cases.Uneven enhancement and asymmetric localized thickening of the intestinal wall are more common in small intestinal adenocarcinoma, stromal tumors and metastases, and homogeneous enhancement and symmetrical segmental thickening of the intestinal wall are more common in inflammatory or infectious diseases, small bowel obstruction.Segmental or diffuse thickening of the intestinal wall was mainly found in benign lesions except lymphoma. Laminar enhancement of thickened intestinal wall was more common in inflammatory or infectious diseases.The enlargement of adjacent lymph nodes in thickened intestinal wall was more common in Crohn's disease and tuberculosis of small intestinal malignant tumor, and abnormal adjacent mesenteric vessels were found in small intestinal obstruction, inflammatory or infectious diseases.Conclusion the length, symmetry, enhancement mode and abnormal pericardium of intestinal wall thickening are helpful for the diagnosis and differential diagnosis of small intestinal tumors, small bowel obstruction, enteritis or infectious diseases.
【作者单位】：贵阳医学院附属医院影像科;湖南医药学院医学影像教研室;贵州省贵阳市修文县人民医院影像科;
【基金】：贵州省卫生厅基金资助课题(gzwkj2010-1-019) 贵阳医学院院基金资助课题
【分类号】：R574.5;R816.5

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