目的 探讨小肠CT三维成像对 Peutz-Jeghers综合征的诊断及临床应用 价值。方法 搜集长海医院收治的经病理 证实的PJS患者18例，男女各9例，所有 病例均行小肠CT三维检查，分析其CT表 现，并结合临床资料进行回顾性分析。结 果 18例均有皮肤色素沉着，18例均以反 复腹痛为首发症状，8例有黑便，6例有肠 梗阻病史，5例有肠套叠病史，2例肠镜后 出现肠穿孔。1例伴发左乳纤维腺瘤。错 构瘤性息肉12例(66.7%)，炎性息肉3例 (16.7%)，绒毛-管状腺瘤2例(11.1%)，增 生性息肉1例(5.5%)。息肉累及胃9例，小 肠18例，结肠16例。息肉大小(1.0-4.5) cm，有或无蒂，类圆形或分叶状，增强后 见条状小血管由肠壁进入息肉内。肠套叠 可见典型的“靶征”、“双肠管征”。结 论 Peutz-Jeghers综合征临床表现特异， 小肠CT三维成像诊断胃肠道息肉及有无肠 套叠准确性高，同时作为一种无创检查， 利于定期复查。

Objective To investigate the diagnosis and clinical value of small bowel CT three-dimensional imaging in Peutz-Jeghers syndrome. Methods 18 cases of PJS confirmed by pathology in changhai hospital were collected, including 9 males and 9 females. All cases underwent small bowel CT three-dimensional examination. The clinical manifestations of these patients were analyzed retrospectively. Results Skin pigmentation were found in 18cases, recurrent abdominal pain as the first symptom in 18 cases, black stool in 8 cases. 6 cases were present with intestinal obstruction, 5 cases with intussusception, 2 cases with intestinal perforation after colonoscopy. 1 case was accompanied by left breast fibroadenoma. There were 12 cases (66.7%) of malignant polyps, 3 cases of inflammatory polyps (16.7%), 2 cases of villous tubular adenoma (11.1%), and 1 case of hyperplastic polyps (5.5%). The location of polyps were 9 cases in stomach, 18 cases in small intestine, and 16 cases in colon. The size of polyps were from 1.0 cm to 4.5cm. The polyps were pedunculated or sessile, round or lobulated, Small strips of vessels entered the polyps from the intestinal wall after enhancement. The typical target sign and double bowel sign were found in the cases with intussusception. Conclusion The Clinical manifestations of Peutz-Jeghers syndrome was special. The small bowel CT threedimensional diagnosis of gastrointestinal polyps with or without intussusception was of high accuracy, and it could be used as a noninvasive examination for following-up.