多层螺旋CT对Lemmel's综合征的诊断价值

Diagnostic value of helical CT in Lemmel's syndrome

目的探讨多层螺旋CT(MSCT)对Lemmel's综合征(十二指肠乳头旁憩室)的诊断价值。方法对经MSCCT检查确诊的32例十二指肠乳头旁憩室患者的影像资料进行回顾性直径分析。结果 32例患者共发现十二指肠乳头旁憩室32个,其中29个憩室壁菲薄,3个憩室壁增厚,憩室1.0～4.9 cm。十二指肠乳头旁憩室表现为十二指肠环内侧囊袋状突出于十二指肠小弯侧壁,其内多为气体密度影,其中可见气-液平面9例,表现为囊性低密度结节3例,不均匀实性结节3例,增强扫描显示憩室壁强化与十二指肠壁具有一致性,其内无强化。32例病例胆管系统均伴有不同程度的扩张。多平面重组和三维重组可清楚显示憩室与十二指肠及十二指肠乳头的毗邻关系。结论 MSCT对Lemmle's综合征的诊断具有较高的准确性,对本病的诊断具有重要价值。

Objective To evaluate the features and diagnostic value of multi-slice helical CT （MSCT） in Lemmel＇s syndrome. Methods MSCT of 32 patients with duodenal diverticula was analyzed retrospectively. Results Of 32 duodenal diverticula in 32 patients, the diverticular wall was thin in 29 and thick in 3 with wall thickness ranging from 1.0 to 4.9 cm. In the inner wall of the duodenal loop, most of the diverticula showed gas density with gas-fluid level （9）, low-density cystic nodule （3） and heterogeneous solid nodule （3）. The diverticular wall enhanced similar to the duodenal wall. Varying degree of bile duct dilatation was noted on all patients. The relationship among diverticulum, duodenum and duodenal papilla was clearly demonstrated on the three-dimensional multi-planar reconstruction. Conclusion MSCT is highly accurate for diagnosis of Lemmel＇s syndrome.