十二指肠壅积症的CT影像分析

CT Imaging Analysis of Duodenal Stasis Disease

目的探讨十二指肠壅积症(DSD)的多层螺旋CT影像表现及诊断价值。方法对17例DSD患者(实验组)及20例无症状的成年人(对照组)进行仰卧位多层螺旋CT检查,分析两组人群十二指肠和肠系膜上动脉(SMA)的CT影像表现,比较两组的影像差异。结果 DSD的CT影像包括胃十二指肠球部、降段及部分水平段扩张,SMA对十二指肠水平段造成压迹,十二指肠水平段充盈不佳、管腔狭窄等改变;实验组SMA与腹主动脉(AO)的夹角与对照组相近,两组间无显著差异(t=0.713,P>0.20);实验组SMA与AO间距较对照组小,但两组间无显著差异(t=0.545,P>0.25)。实验组SMA与AO间距<10 mm者有10例(58.82%)、SMA与AO夹角<30°者有11例(64.71%),而对照组SMA与AO间距<10 mm者7例(35%)、SMA与AO夹角<30°者4例(20%),但两组之间SMA与AO间距及夹角的差异均不具有统计学意义(精确概率P=0.068,0.071)。实验组中11例SMA与AO夹角<30°的患者,这11例患者与实验组之间SMA与AO夹角的差异也不具有统计学意义(t=0.768,P>0.10)。结论多层螺旋CT观察十二指肠的形态变化有利于DSD的诊断,但单纯测量SMA与AO间距和夹角是否能确诊DSD则难以定论。

Objective To investigate imaging findings and diagnostic value of multi slice spiral CT（MSCT） for the duo- denal stasis disease （DSD）. Methods MSCT were performed for 17 cases with DSD （ experimental group） and 20 cases with asymptomatic adults （control group）. CT image findings of duodenum and superior mesenteric artery （SMA） were analyzed in two groups. Image differences of duodenum and SMA were compared between experimental group and control group. Results CT appearance of DSD included expansion of stomach and descending duodenal,pressure trace caused by superior mesenteric artery in duodenal horizontal segment, poor filling of contrast material in duodenum horizontal section, duodenum stenosis, et al. The angles between SMA and abdominal aorta（AO） was similar in experimental group and in con- trol group, there was not significantly different between two groups （ t = 0. 713, P 〉 0.20 ）. The distance between SMA and AO was smaller in experimental group than that in control group, but there was also a significant difference （ t = 0. 545, P 〉 0.25）. For experimental group,the distance between SMA and AO was less than 10 mm in I0 cases （58.82%） and angle between SMA and AO was less than 30 degrees in 11cases（64.71% ）. For control group,the distance between SMA and Ao was less than 10 mm in 7 cases（35% ）and angle between SMA and AO was less than 30 degrees in 4 cases（20% ） ,but the differences of distance and angle between the two groups were not statistically significant （ respectively P = 0. 068, 0.071 ）. There were 11 cases with angle less than 30 degrees between SMA and AO in experimental group, no significant differences of angle between the 11 cases and control groups was found （t = 0. 768,P 〉 0.10）. Conclusion CT is useful for diagnosis of DSD, but it is uncertain to measure simply the spacing and angle between SMA and AO for diagnosis of DSD.