胃十二指肠病变的CT表现及其诊断价值

CT Diagnosis of Gastroduodenal Diseases

目的:报道胃十二指肠病变的 CT 表现,并评价其价值。材料与方法:对37例上腹部不适患者行常规腹部 CT 扫描,总结胃十二指肠壁、肠腔及外周脂肪的改变。结果:由 CT 扫描首先发现病灶而提示诊断的共24例。19例进展期胃癌表现为胃壁不规则增厚,3例形成向腔内突出的肿块,3例见溃疡,胃周脂肪层变薄、密度增高或消失者共11例。另外,胃淋巴瘤,肥厚性胃炎,胰腺病变及结肠癌浸润等亦可导致胃壁增厚及周围脂肪层改变。胃平滑肌肉瘤表现为胃腔外巨大软组织肿块,其内可见坏死性低密度区,并可见坏死区与胃腔相通。结论:在阅读上腹部 CT 片时,除对实质性器官观察外,还应注意胃十二指肠等空腔脏器,以发现胃十二指肠的病变。管壁增厚及脂肪层的改变是诊断胃十二指肠的直接征像,但无特异性。

Objective:To report the CT appearence and assese the diagnostic value of gastroduodenal diseases.Materials and Methods:37 patients with gastroduodenal diseases,proved by pathology or clinical method,underwent CT scan.The change of gastroduodenal wall and sorrounding fat plane were analysed.Results:Among these patients,CT scan first discovered the lesions in 24 cases.CT can demonstrate iregular thickening of gastric wall in 19 advanced gastric adenocarcinoma.The intraluminal mass and ulceration in the massive thickening wall can be seen in 3 of 19 cases.Blurring or thinning of the surrounding fat plane can be seen in 11 cases.Besides gastric carcinoma,a wide variety of pathologic entities produced gastric wall thickening,such as lym- phoma,gastritis,acute pancreatitis and colon carcinoma.Leiomyosarcoma of stomach presents a large exogastric mass with necrotic decreased attenuation within it.Conclusion:We must pay attension to gastroduodum at the time of reading upper abdominal CT film.The gastric wall thickening demonstrated on CT were direct sign of gastroduodenal diseases,but it ultimately must be consi- dered nonspecific.