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目的 评价CT在原发十二指肠癌诊断中的价值。方法 对 15例经手术、病理证实的原发十二指肠癌 (腺癌 12例 ,类癌3例 )的CT表现进行回顾性分析。结果 9/ 12例腺癌表现为局部软组织肿块 ;6 / 12例腺癌表现为肠壁不规则形或环形增厚 ;表现为局部软组织肿块同时伴有肠腔变形、狭窄者 3例 ;可伴有肝内外胆管扩张 ,腹膜后淋巴结及肝内转移。仅凭CT无法区分类癌和腺癌。CT增强多表现为软组织肿块早期呈轻至中度强化 ,延迟后或门脉期则强化不明显。结论 CT对原发十二指肠癌的定位、定性诊断非常有价值 ,但对腺癌和类癌的鉴别尚有困难。
Objective To evaluate the value of CT in the diagnosis of primary duodenal cancer. Methods CT findings of 15 cases of primary duodenal cancer (adenocarcinoma 12 cases, 3 cases of carcinoid) confirmed by surgery and pathology were retrospectively analyzed. Results 9/12 cases of adenocarcinoma showed local soft tissue mass; 6/12 cases of adenocarcinoma showed irregular or annular thickening of the intestinal wall; local soft tissue mass was accompanied by 3 cases of intestinal deformation and stenosis; Intrahepatic bile duct dilatation, retroperitoneal lymph nodes and intrahepatic metastasis. CT alone cannot classify cancer and adenocarcinoma. CT enhancement mostly manifested as mild to moderate enhancement in the early stage of soft tissue mass, and no significant enhancement after delay or in portal phase. Conclusion CT is valuable for the localization and qualitative diagnosis of primary duodenal cancer, but it is difficult to distinguish between adenocarcinoma and carcinoid.