原发性小肠腺癌与小肠淋巴瘤的多层螺旋CT表现及鉴别诊断

Multi-slice spiral CT features of and differential diagnosis primary intestinal adenocarcinoma and primary intestinal lymphoma

目的探讨螺旋CT对原发性小肠腺癌与原发性小肠淋巴瘤的诊断价值。方法选择河北省玉田县医院及河北联合大学附属医院2009年10月-2014年10月收治的经病理诊断确诊的原发性小肠腺癌21例及原发性小肠淋巴瘤23例,对44例患者行螺旋CT检查,对两种恶性肿瘤的发病部位和CT特征进行分析。结果原发性小肠腺癌发病部位：十二指肠16例,空肠3例,回肠2例：原发性小肠淋巴瘤发病部位：十二指肠2例,空肠5例,回肠16例,两种小肠恶性肿瘤发病部位比较差异有统计学意义（P〈0.05）。螺旋CT增强扫描中,小肠腺癌动脉期、静脉期CT值分别为（104.9±9.1）、（95.6±8.9）ttu,显著高于原发性小肠淋巴瘤[（45.4±8.9）、（69.1±8.0）Hu],差异有统计学意义（P〈0.05）。结论螺旋CT检查对原发性小肠淋巴瘤和小肠腺癌的鉴别诊断具有较高的临床价值,两者各具特征性表现,值得临床广泛应用。

Objective To investigate the value of spiral CT in the diagnosis of primary intestinal adenocarcinoma and primary intestinal lymphoma.Methods From October 2009 to October 2014,in Yutian County Hospital and Affiliated Hospital of Hebei United University,21 patients with primary intestinal adenocarcinoma and 23 patients with primary intestinal lymphoma were selected,who were diagnosed by pathological diagonosis.44 patients were underwent spiral CT examination,tumor location and CT features of two kinds of malignant tumors were analyzed.Results Location of primary intestinal adenocarcinoma：16 cases were in duodenum,3 cases were in jejunum,2 cases were in ileum.Location of primary intestinal lymphoma：2 cases were in duodenum,5 cases were in jejunum,16 cases were in ileum,the two kinds of tumors location were compared,the difference was statistically significant（P〈0.05）.CT value of arterial phase and venous phase were（104.9±9.1）,（95.6±8.9） Hu in intestinal adenocarcinoma,which were significantly higher than those of intestinal lymphoma[（45.4±8.9）,（69.1±8.0） Hu]in contrast enhanced spiral CT,the differences were statistically significant（P〈0.05）.Conclusion The clinical value of spiral CT examination has a high degree in the diagnosis and differential diagnosis of primary intestinal lymphoma and adenocarcinoma.The diagnotic method is worthy of clinical wide application.