CT小肠造影对小肠肿瘤及肿瘤样病变的诊断与鉴别诊断的价值

Value of CT enterography in the diagnosis and differential diagnosis of small intestinal tumors and tumor-like lesions

目的探讨CT小肠造影(CTE)对小肠肿瘤及肿瘤样病变的诊断与鉴别诊断的价值。方法回顾性分析2015年1月—2022年12月于我院行CTE检查且手术病理检查证实为小肠肿瘤及肿瘤样病变的74例患者的影像学资料,根据病变性质分为恶性肿瘤组(54例)和非恶性肿瘤及肿瘤样病变组(20例),对两组患者的肿瘤长径、肠腔残留率及三期CT值(平扫、动脉期及静脉期)进行比较。结果恶性肿瘤组患者肿瘤长径、平扫CT值均显著高于非恶性肿瘤及肿瘤样病变组(Z=-3.512、-3.214,P<0.05),动脉期及静脉期CT值显著低于非恶性肿瘤及肿瘤样病变组(Z=-4.163、-3.475,P<0.05),肠腔残留率无显著差异(P>0.05);恶性肿瘤组中淋巴瘤患者的肿瘤长径和肠腔残留率显著高于腺癌患者(Z=-3.161、-4.853,P<0.05),动脉期及静脉期CT值显著低于腺癌患者(Z=-2.353、-2.161,P<0.05);剔除淋巴瘤患者后,两组患者的肿瘤长径、三期CT值有显著差异(Z=-3.571~-2.611,P<0.05),肠腔残留率仍无显著差异(P>0.05)。结论CTE能充分显示小肠肿瘤及肿瘤样病变的特征,可以为其诊断与鉴别诊断提供依据。

Objective To investigate the value of CT enterography(CTE)in the diagnosis and differential diagnosis of small intestinal tumors and tumor-like lesions.Methods A retrospective analysis was performed for the imaging data of 74 patients who underwent CTE in our hospital from January 2015 to December 2022 and were diagnosed with small intestinal tumors and tumor-like lesions based on pathological examination,and according to the nature of lesions,they were divided into malignant tumor group with 54 patients and non-malignant+tumor-like lesion group with 20 patients.The two groups were compared in terms of major axis of tumor,intestinal residual rate,and CT values during plain scan phase,arterial phase,and venous phase.Results Compared with the non-malignant+tumor-like lesion group,the malignant tumor group had significantly higher major axis of tumor and CT value during plain scan phase(Z=-3.512,-3.214,P<0.05)and significantly lower CT values during arterial phase and venous phase(Z=-4.163,-3.475,P<0.05),while there was no significant difference in intestinal residual rate between the two groups(P>0.05).In the malignant tumor group,compared with the patients with adenocarcinoma,the patients with lymphoma had significantly higher major axis of tumor and intestinal residual rate(Z=-3.161,-4.853,P<0.05)and signi-ficantly lower CT values during arterial phase and venous phase(Z=-2.353,-2.161,P<0.05).After the patients with lymphoma were excluded,there were still significant differences in major axis of tumor and CT values during the three phases between the two groups(Z=-3.571--2.611,P<0.05),with no significant difference in intestinal residual rate(P>0.05).Conclusion CTE can fully display the features of small intestinal tumor and tumor-like lesions and thus provide a basis for the diagnosis and differential diagnosis of these diseases.