胃肠道脂肪瘤及其并发症MSCT表现

MSCT manifestations of gastrointestinal lipoma and its complications

目的探讨胃肠道脂肪瘤及其并发症的MSCT表现。方法回顾性分析258例MSCT检查发现胃肠道脂肪瘤患者的临床、病理及影像学资料,患者均接受MSCT平扫+增强扫描。结果258例中,单发230例(230/258,89.15%),多发28例(28/258,10.85%),共发现脂肪瘤296个。单发肿瘤以空肠近段最常见(81/230,35.39%),其次是十二指肠(69/230,30.00%),直肠最少(1/230,0.43%)。病变体积0.000 9~198.59cm^3,中位数[0.71(0.31,1.75)]cm^3。肿瘤CT值-258^-35HU,增强扫描均无强化。296个脂肪瘤中,圆形147个(147/296,49.66%),椭圆形111个(111/296,37.50%),不规则形17个(17/296,5.74%),条状20个(20/296,6.76%),锥形1个(1/296,0.34%)。肿瘤并发肠梗阻18例(18/258,6.98%),其中重度梗阻6例,中度5例,轻度7例。并发肠梗阻、并发肠套叠及无并发症的脂肪瘤体积分别为(55.22±20.64)cm^3、(20.54±16.22)cm^3和(11.24±8.97)cm^3(F=140.200,P<0.001)。结论胃肠道脂肪瘤体积和CT值可能是引起继发性肠套叠和肠梗阻的主要风险因素。MSCT能准确评估胃肠道脂肪瘤及其并发症。

Objective To explore MSCT manifestations of gastrointestinal lipoma and its complications.Methods Clinical,pathological and imaging data of 258 patients with gastrointestinal lipoma were analyzed retrospectively.All patients underwent MSCT and multiphase enhanced scanning.Results A total of 296 lipomas were found in 258 patients,230 patients（230/258,89.15%）had single lesion and 28（230/258,10.85%）had multiple lesions.The location of single lipoma was the most common in the proximal jejunum（81/230,35.39%）,followed by duodenum（69/230,30.00%）,and the least rectum（1/230,0.43%）.The lesion volume ranged from 0.000 9 cm3 to 198.59 cm3,with a median of（0.71[0.31,1.75]）cm3.CT value of lipomas ranged from-258 HU to-35 HU,and no enhancement was found.Round shape lesions were found in 147 lipomas（147/296,49.66%）,oval in 111 lipomas（111/296,37.50%）,irregular in 17 lipomas（17/296,5.74%）,elongated in 20 lipomas（20/296,6.76%）and conical in 1 lipoma（1/296,0.34%）.Eighteen patients（18/258,6.98%）had secondary intestinal obstruction,including severe in 6,moderate in 5 and mild in 7 patients.The volume of lipoma was significantly different among patients with intestinal obstruction（[55.22 ±20.64]cm3）,with intussusception（[20.54±16.22]cm3）and patients without complications（[11.24±8.97]cm3;F=140.200,P0.001）.Conclusion The size and CT value of gastrointestinal lipomas may be the main risk factors resulting in secondary intussusception and intestinal obstruction.MSCT can make accurate assessment of gastrointestinal lipoma and its complications.