小儿消化道重复畸形的影像诊断(附12例分析)

Imaging diagnosis of duplication of the alimentary tract in child

目的:探讨小儿消化道重复畸形的影像学表现及各种影像检查的价值。方法:分析经手术病理证实的12例小儿消化道重复畸形的临床、病理和X线、CT及超声表现。结果:直肠重复畸形1例占8.3%,胃重复畸形1例占8.3%,小肠重复畸形10例占83.4%。7例腹部平片2例表现完全性肠梗阻,3例不全性肠梗阻,2例见肿块影;7例消化道造影中,3例胃、肠道受压,并可见占位征象,1例钡剂灌肠检查回盲部充盈欠佳;1例肠套叠复位后腹腔内仍见包块影;其余2例造影检查阴性。8例BUS中,6例腹腔见囊性包块,1例表现为肠梗阻;1例表现为腹膜炎,腹腔少量积液。4例CT表现为单房囊性肿块,囊内CT值近似于水,囊壁与邻近肠管壁厚相近或稍厚,增强扫描囊壁均匀强化。结论:综合应用各种影像检查方法对正确诊断小儿消化道重复畸形有重要价值。

Objective： To investigate the imaging manifestations and the value of various imaging examinations of duplication of the alimentary tract in children. Methods： Imaging findings, clinical data and pathological results of 12 cases with histologically proved duplication of the alimentary tract were retrospectively analyzed. Results： Of the 12 cases, there were 1 case of rectal duplication, 1 case of gastric duplication, 10 cases of intestinal duplication. Abdominal plain film showed complete obstruction in 2 cases, incomplete obstruction in 3 cases and mass in 2 cases. Barium/air GI examination or enema was performed in 7 cases, in which 3 cases had mass effect, 1 case had filling defect, 1 case had mass after relocation of intussusception, 2 cases had normal appearances. BUS was performed in 8 cases in which 6 cases showed cystic lesions, 1 case showed intestinal obstruction and 1 case showed peritonitis. CT revealed fluid density, unilocular cyst in 4 cases, cystic wall was thick, and were enhanced after enhancement. Conclusion： Applications of various imaging examinations had important value to accurately diagnose duplication of the alimentary tract in children.