小肠淋巴瘤与小肠腺癌的多层螺旋CT诊断及鉴别诊断分析(1)
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【摘要】目的 观察分析小肠淋巴瘤与小肠腺癌的多层螺旋CT的检查方法及结果，总结其诊断及鉴别诊断价值。方法 选取我院自2008年1月~2010年12月收治的经病理确诊为小肠淋巴瘤和小肠腺癌患者，各18例，观察对比两组患者的病灶好发部位、范围及淋巴结转移的情况，记录相关情况进行统计学分析。结果 小肠腺癌好发于小肠近端，其发病范围有局限性，主要表现为环形累及肠壁及小肠腔内软组织结节，病灶的强化模式为“快速上升-平台”，伴肝转移及周围小淋巴结，病变侵袭胰腺，肝内、外胆管及胰管扩张等，经三维血管成像(CTA)检查可见明显的 “肿瘤染色”征象；小肠淋巴瘤好发于小肠远端，其发病范围广，病灶的强化模式为“缓慢上升”，伴肠系膜或后腹膜的淋巴结肿大，经三维血管成像(CTA)检查可见明显的“肿瘤包绕血管”征象；两组检查结果存在一定差异(P<0.05)，具有统计学意义。结论 多层螺旋CT扫描对分析小肠淋巴瘤与小肠腺癌的病因及病情发展等情况有重要的临床诊断意义，并且对于两者在CT及CTA下的特征性改变，可用于临床鉴别诊断。
【关键词】小肠淋巴瘤 小肠腺癌 多层螺旋CT
中图分类号：R814.42文献标识码：A文章编号：1005-0515(2011)12-049-02
【Abstract】Objective To observe the analysis of small intestinal lymphoma and small bowel adenocarcinoma of spiral CT screening method and results, summarize the diagnosis and differential diagnosis. Methods In our hospital from January 2008 - December 2010 were treated by the pathological diagnosis of small bowel lymphoma and small bowel adenocarcinoma patients, all 18 cases, observed and compared two groups of patients with lesions of location, extent and lymph node metastasis , recording the relevant information for statistical analysis. Results The intestinal adenocarcinoma occurs in the proximal small intestine, and its incidence range limitations, mainly involving the intestinal wall and intestinal cavity ring soft tissue nodules, lesions of the enhanced mode for the "rapid rise - platform", with liver metastasis and around the small lymph nodes, invasion of pancreatic disease, liver, bile duct and pancreatic duct dilation, the three-dimensional angiography (CTA) examination showed obvious "tumor stain" signs; intestinal lymphomas occur in the distal small intestine, the incidence of a wide range of lesion enhancement pattern of "slow up", with mesenteric or retroperitoneal lymph nodes, the three-dimensional angiography (CTA) examination showed significant "tumor blood vessels surrounding the" signs; two test results there are some differences (P <0.05), with statistical significance. Conclusion the analysis of multi-slice spiral CT scan and small bowel adenocarcinoma of the small intestine lymphoma etiology and progression of the disease, etc ......
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