Department of Radiological Sciences, Sapienza University of Rome, Rome, Italy.
Br J Radiol. 2011 Aug;84(1004):677-90. doi: 10.1259/bjr/20673379. Epub 2011 May 17.
Small bowel neoplasms, including adenocarcinoma, carcinoid tumour, lymphoma and gastrointestinal stromal tumours, represent a small percentage of gastrointestinal cancers, yet are among those with the poorest prognosis compared with other gastrointestinal malignancies. Unclear clinical scenarios and difficult radiological diagnosis often delay treatment with negative effects on patient survival. Recently, multidetector CT (MDCT) and MRI have been introduced as feasible and accurate diagnostic techniques for the identification and staging of small bowel neoplasms. These techniques are gradually replacing conventional barium radiography as the tool of choice. However, the inherent technical and physiological challenges of small bowel imaging require a familiarity with patient preparation and scan protocols. Adequate knowledge of the histopathology and natural evolution of small bowel neoplasms is also important for differential diagnosis. The aim of this article is to review MDCT and MRI protocols for the evaluation of small bowel tumours and to provide a concise yet comprehensive guide to the most relevant imaging features relative to histopathology.
小肠肿瘤,包括腺癌、类癌肿瘤、淋巴瘤和胃肠道间质瘤,占胃肠道癌的一小部分,但与其他胃肠道恶性肿瘤相比,其预后最差。不明确的临床情况和困难的放射学诊断常常导致治疗延迟,对患者的生存产生负面影响。最近,多排 CT(MDCT)和 MRI 已被引入作为识别和分期小肠肿瘤的可行和准确的诊断技术。这些技术正在逐渐取代传统的钡造影作为首选工具。然而,小肠成像固有的技术和生理挑战需要熟悉患者准备和扫描方案。充分了解小肠肿瘤的组织病理学和自然演变对于鉴别诊断也很重要。本文的目的是回顾评估小肠肿瘤的 MDCT 和 MRI 方案,并提供一个简洁而全面的与组织病理学相关的最相关影像学特征指南。