小肠原发性肿瘤的影像诊断(附30例分析)

Imaging diagnosis of primary small intestinal tumor (analysis of 30 cases)

目的:探讨小肠原发性肿瘤的影像学特征及检查方法。方法:30例均行口服法小肠气钡双对比造影检查,其中2例行CT扫描,1例行MRI检查,全部病例均经手术病理证实。结果:30例中,腺癌9例,平滑肌肉瘤5例,腺瘤或息肉7例,类癌、间质瘤、管状腺瘤、神经节细胞瘤各2例,血管瘤1例。发生于十二指肠15例,空肠13例、回肠2例。恶性肿瘤多表现为:肠黏膜破坏,腔内或腔外不规则龛影,肠管局限性狭窄,壁僵硬,蠕动消失。良性肿瘤多表现为:肠腔内圆形、卵圆形充盈缺损,边缘光滑,形态可变,黏膜平坦。肠壁软,蠕动正常。肿瘤向肠腔外生长者B超、CT、MRI检查占有优势。结论:对临床疑诊为原发性小肠肿瘤者应首选小肠气钡双对比造影检查,小肠双对比造影检查与CT扫描相结合可提高诊断准确率。

Objective：To explore the imaging character of primary small intestinal tumor and the diagnosis method, Methods：Thirty cases of primary small intestinal tumor proved by operation and pathology were studied by air-barium double contrast enhanced examination. Two cases were examined by CT and one case was examined by MRI. Results：Thirty patients were studied, including nine adenocarcinoma, five leiomyosarcoma, seven adenoma or polyp, two carcinoid, two interstitialoma, two tubular adenoma, two ganglioneuroma and one hemangioma. The tumor on duodenum in fifteen cases, jejunum in thirteen cases and ileum in two cases. Malignant tumor was showed destruction of intestinal mucous and abnormal crater in or out the intestinal lumen. Partial stenosis, partial stiffening and disappearance of peristalsis were observed. The benign tumor was showed circular or oviform filling defect with smooth boundary, alterable shape and flat mucous. The intestinal wall was soft and had normal peristalsis wave. US, CT and MRI were dominant in diagnosis of tumor growing out of intestinal. Conclusion： For patients suspected primary small intestinal tumor, air-barium double contrast enhancement examination should be performed first. It can improve the diagnosis accuracy when associated by CT.