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CT 诊断小肠原发性肿瘤:临床医师读图指南

Primary neoplasms of the small bowel at CT: a pictorial essay for the clinician.

机构信息

Department of Bio-Imaging and Radiological Sciences, Radiology Institute, Catholic University of the Sacred Heart, Gemelli Foundation, School of Medicine, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2018 Feb;22(3):598-608. doi: 10.26355/eurrev_201802_14281.

Abstract

OBJECTIVE

Primary small intestinal neoplasms are uncommon tumors that are often small and difficult to identify. The aim of this paper is to describe CT technique and features in detecting and characterizing the tumors of the small bowel.

MATERIALS AND METHODS

This paper focuses on radiological characteristics of benign and malignant primary neoplasms of the small bowel at CT, with special reference to multidetector-CT techniques, type and modality of administration of contrast agents (by oral route or CT-enterography and by nasojejunal tube or CT-enteroclysis). This paper will also provide pictures and description of CT findings of benign and malignant primary neoplasms using examples of CT-enterography and CT-enteroclysis.

RESULTS

Among CT modalities, CT-enterography has the advantage of defining the real extension of wall lesions, possible transmural extension, the degree of mesenteric involvement and remote metastasis. Other useful modalities for the diagnosis of such lesions like capsule endoscopy and enteroscopy, provide important information but limited to mucosal changes with lower accuracy on extension and bowel wall involvement or submucosal lesions.

CONCLUSIONS

Multidetector-CT, performed after distension of the small bowel with oral contrast material and intravenous injection of iodinated contrast material, is a useful method for the diagnosis and staging of small bowel neoplasms.

摘要

目的

原发性小肠肿瘤是少见的肿瘤,通常较小且难以识别。本文旨在描述 CT 技术在检测和诊断小肠肿瘤方面的特点。

材料与方法

本文重点介绍了 CT 对小肠良、恶性原发性肿瘤的影像学特征,特别参考了多排螺旋 CT 技术、对比剂的给药方式(口服途径或 CT 肠造影,经鼻胃管或 CT 肠灌洗)。本文还将通过 CT 肠造影和 CT 肠灌洗的例子,提供良、恶性原发性肿瘤的 CT 表现的图片和描述。

结果

在 CT 检查方法中,CT 肠造影具有定义壁病变的实际范围、可能的壁内扩展、肠系膜受累程度和远处转移的优势。其他用于诊断这些病变的有用方法,如胶囊内镜和小肠镜,提供了重要信息,但仅限于黏膜变化,对扩展和肠壁受累或黏膜下病变的准确性较低。

结论

多排螺旋 CT 检查,通过口服对比剂扩张小肠和静脉注射碘对比剂,是诊断和分期小肠肿瘤的有用方法。

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