Minami M
Department of Radiology, Faculty of Medicine, University of Tokyo.
Nihon Igaku Hoshasen Gakkai Zasshi. 1999 Sep;59(11):496-503.
Five topics regarding CT diagnosis of the gastrointestinal tract are discussed with illustrative cases: 1) Fat-containing tumors can be seen in the esophageal lumen, and their differential diagnosis includes not only lipoma and liposarcoma (sometimes teratoma) but also fibrovascular polyp and carcinosarcoma. 2) The multi-layered pattern of the gastric wall observed on dynamic CT is important for the differential diagnosis of gastric lesions and the staging of gastric cancer. 3) Swelling of the sentinel lymph nodes is an important finding for correct staging of cancer, incidental detection of occult cancer, and diagnosis of the origin of abdominal tumors. 4) Air-inflated CT and virtual CT endoscopy of the colon are necessary for the detection of small colorectal cancers, and multi-planar reconstruction (MPR) images vertical to the lesions are helpful for cancer staging. 5) MRI and CT with MPR images are useful for the evaluation of anorectal fistula.
本文结合实例探讨了胃肠道CT诊断的五个主题:1)食管腔内可见含脂肪肿瘤,其鉴别诊断不仅包括脂肪瘤、脂肪肉瘤(有时为畸胎瘤),还包括纤维血管息肉和癌肉瘤。2)动态CT观察到的胃壁多层模式对胃病变的鉴别诊断和胃癌分期很重要。3)前哨淋巴结肿大是癌症正确分期、隐匿性癌症偶然发现以及腹部肿瘤起源诊断的重要发现。4)结肠充气CT和虚拟CT内镜检查对于小的结直肠癌检测是必要的,垂直于病变的多平面重建(MPR)图像有助于癌症分期。5)MRI和带有MPR图像的CT对肛管直肠瘘的评估很有用。