十二指肠乳头癌的螺旋CT诊断

Spiral CT Diagnosis in Carunculae Major Carcinoma

目的探讨十二指肠乳头癌的螺旋CT表现及鉴别诊断要点。资料与方法回顾性分析螺旋CT检查后经手术病理证实并有完整病史资料的病例17例。结果十二指肠乳头癌的CT表现:(1)胆囊增大,肝内外胆管呈普遍性一致性扩张,胆总管及胰管明显扩张,并于胆总管远端突然截断,梗阻处断面平直。(2)十二指肠降部肠壁内侧部突出软组织肿块影,呈圆形、分叶状及菜花状,以圆形多见,密度均匀,无钙化及囊变,与十二指肠断面呈"双环征",且内环相切,增强扫描肿块呈均匀性强化者14例,3例呈不均匀性强化。结论螺旋CT是十二指肠乳头癌诊断有效的影像学检查方法。

Objective To discuss CT appearances and differential diagnosis value of carunculae major carcinoma （CMC）. Materials and Methods CT data and clinical information of 17 cases of CMC, confirmed by surgical pathology, were retrospectively analyzed. Results The CT features included ： （ 1 ） gallbladders were expended, Intrahepatic and extrahepatic bile ducts were generally distended. Bile commen ducts and canals of wirsung were obviously distended,and suddenly cut off at the distal end of bile commen ducts With straight margin. The soft tissue lumps outpocketed from medial wall of descendant duodenum with round, sublobe and cauliflower shape. The round shape mass was the most frequent type. The density was homogeneous, non-calcification and cystis degeneration. Bicyclo sign was showed on the border of mass and duodenum, with inner ring mutually incide. On contrast enhanced spiral CT, 14 cases showed homogeneous attenuation and 3 cases showes heterogeneous attenuation. Conclusion Spiral CT is an effective imaging method to diagnosis carunculae major carcinoma.