十二指肠乳头旁憩室综合征影像学表现及分型的临床价值

Clinical Value of Imaging Findings and Classification of Juxtapapillary Duodenal Diverticulum Syndrome

目的分析十二指肠乳头旁憩室综合征的影像学表现、分型,探讨多层螺旋CT在该病诊断中的临床价值。方法选出本院2019年10月—2020年10月诊治的40例十二指肠乳头旁憩室综合征患者为研究对象,均对其行多层螺旋CT检查,分析其影像学表现以及分型与分级的检查情况。结果共检出十二指肠乳头旁憩室47个,其中33例为单发憩室,7例为多发憩室。影像学表现主要为十二指肠内侧壁向腔外隆起的囊袋状病灶,薄层面可见病灶和十二指肠腔连通的窄小颈部,17例囊腔中含有气液平面;增强扫描17例憩室壁出现轻中度强化,憩室形态、大小不一。憩室分型中,中心型28例,周围型12例,合并胆管扩张38例,胆管结石16例,胆囊炎10例,胆囊结石9例。憩室分级中,I型19例,II型11例,III型6例,IV型4例。结论多层螺旋CT在十二指肠乳头旁憩室综合征诊断中的应用价值高,影像学表现具有一定的典型性;十二指肠乳头旁憩室综合征的分型与分级可指导临床治疗方案的制定,对提高该病的治疗效果具有显著意义。

Objective To analyze the imaging features and classification of duodenal juxtapapillary diverticulum syndrome,and to explore the clinical value of multi-slice spiral CT in the diagnosis of the disease.Methods 40 cases of patients with juxtapapillary diverticulum syndrome in our hospital from October 2019 to October 2020 were selected as the research objects.All patients were examined by multi-slice spiral CT,and the imaging manifestations,classification and classification were analyzed.Results 47 diverticulum were detected,33 of them were single diverticulum and 7 were multiple diverticulum.The imaging findings were mainly cystic cystic lesions with the medial wall of duodenum protruding to the outer cavity.The narrow neck connecting the lesions and duodenal cavity was seen on the thin layer,and the gas-liquid plane was found in 17 cases of the capsule cavity;17 cases of enhanced scanning showed light and moderate enhancement,and the shape and size of diverticulum were different.Among the diverticulum types,28 cases were central type,12 were peripheral type,38 cases were complicated with bile duct expansion,16 cases were bile duct stones,10 cases were cholecystitis,9 cases were gallstone.Among the diverticulum classification,19 cases were type I,11 cases of type II,6 cases of type III and 4 cases of type IV.Conclusion Multi slice spiral CT is of high value in the diagnosis of ppts,and the imaging findings are typical;the classification and classification of ppts can guide the formulation of clinical treatment plan and have significant significance in improving the therapeutic effect of the disease.