论著-头颈部
消化道异位胰腺的MDCT表现分析
作者:陈秀珍1 黄文薮1 陈建宁2 覃 杰1 曾昭吝1 朱康顺1
所属单位:1.中山大学附属第三医院放射科 2.中山大学附属第三医院病理科(广东 广州 510630)
PDF摘要
目的分析消化道异位胰腺的多 层螺旋CT(MDCT)表现,提高诊断的准确 性和鉴别诊断能力。方法 回顾性分析25 例经组织病理学证实的消化道异位胰腺 的MDCT资料,患者术前均行多排螺旋CT平 扫、三期增强扫描及三维重建,观察病灶 的位置、大小、长径与短径的比值、形 态、密度、强化方式、强化程度、生长方 式、病灶边界、病灶表面及周围粘膜情 况,总结该病的CT表现特点。结果 25例 均为单发病灶,9例(36%)发生在胃部,9 例(36%)在十二指肠,5例(20%)在空肠, 2例(8%)在回肠;大小为6mm-25mm;胃病 灶LD/SD>1.4的有7例(78%);十二指肠病 灶LD/SD>1.4的有5例(55%);空回肠病灶 LD/SD均为1.0。15例(60%)为类圆形,4例 为圆形,4例呈不规则形,2例表现为胃肠 壁局部增厚。11例(44%)起源于黏膜下及 肌层,21例(84%)累及黏膜下层。病灶平 扫密度均匀,增强扫描均呈持续性强化, 类似胰腺强化方式;13例(53%)病灶强化 程度与正常胰腺组织相仿;2例显示导管 征;20例(80%)病灶向腔内生长,18例 (72%)病灶边界欠清楚。结论 消化道异位 胰腺的CT表现具有一定特征性,熟悉其特 点可提高对该病的诊断水平。
Objective To analyze the multi-detector computed tomography (MDCT) features of ectopic pancreas in the gastrointestinal tract in order to improve the diagnostic accuracy of the disease. Methods CT findings were reviewed retrospectively in 25 cases with ectopic pancreas confirmed by surgery and pathology.All patients underwent plain CT, contrast-enhanced scanning with three phases and three dimensional reconstruction. Analyze the location, size, the long diameter (LD)/the short diameter(SD), shape, attenuation, contrast-enhancement pattern and grade of the lesions, growth pattern, border, as well as enhancement of the overlying mucosa. Results All 25 cases were of single lesion.9cases were in the gastric.9 cases were in the duodenum, 5 cases were in the jejunum, 2 cases were in the ileum. The max axes ranged from 6-25mm, 7 cases the LD/SD ratio is greater than 1.4 in gastric ectopic pancreas, 5 cases the LD/SD ratio is greater than 1.4 in duodenum. the LD/SD ratio of the jejunum and ileum lesion is 1.0. 15 cases were ovoid in shape, 4 cases were sphere, 4 cases were irregular shape, 2 cases were manifested as Localized thickening of the gastrointestinalwall. 11cases were located in the submucosa and muscularis.The ectopic pancreas was continuously enhanced in all cases,The contrast enhancement grade was similar to that of the normal pancreatic tissue in 13 cases. 2 case showed central duct sign. 20 cases were endoluminal growth pattern. Conclusion Gastrointestinal tract ectopic pancreas has certian MDCT charateristics. It can help us to improve the diagnostic ability of the disease to familiar with these features.
【关键词】异位胰腺;消化道;体层摄影术;X线摄像机
【中图分类号】R322.4+91
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.07.019
前言
异位胰腺又称为迷走胰腺或副胰腺,属于先天畸形,是正常胰腺 解剖部位以外的孤立胰腺组织,和正常胰腺之间无任何解剖、血管关 系[1],文献报道发病率约为1%~13%[2]。异位胰腺易发生囊性变、坏 死,引起黏膜脱垂甚至癌变,有学者认为,一旦发现异位胰腺,就应 该将其手术切除[3];也有学者认为无症状者可定期随访,对于有症状 者,则主张积极治疗[4 5]。由于患者临床表现及实验室检查均缺乏特异 性,异位胰腺常易误诊。本文回顾性分析了25例经手术病理证实的消 化道异位胰腺患者的临床、CT及病理资料,探讨其MDCT表现特征及诊 断价值。
中国CT和MRI杂志
第13卷, 第 7 期
2015年07月
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