Yilmaz Erdem, Kostek Osman, Hereklioglu Savas, Goktas Muhammet, Tuncbilek Nermin
Department of Radiology, School of Medicine, Trakya University, Edirne, Turkey.
Department of Medical Oncology, School of Medicine, Trakya University, Edirne, Turkey.
Curr Med Imaging Rev. 2019;15(10):948-955. doi: 10.2174/1573405614666180904123526.
To demonstrate the prevalence, accompanying pathologies, imaging and follow up findings of Duodenal Diverticula (DD) with Multidetector Computed Tomography (MDCT).
Consecutive 2910 abdominal MDCTs were retrospectively reviewed on axial, coronal and sagittal planes. DD were evaluated for prevalence, location, number, size, contents, diverticular neck, accompanying pancreaticobiliary pathologies, jejunal and colonic diverticula, respectively.
DD were diagnosed in 157 cases (5.4%) and found mostly in the second part of the duodenum. Juxta-ampullary DD was the most common type (78.3%) and mostly located ventral (n:86, 69.9%) to the ampulla of Vater. DD was solitary in 123 patients (78.3%) and more than one in 34 patients (21.7%). The median diameter of DD was 2.5 cm (range 1.5-3.6 cm) in the long-axis. The lumen of DD contains air and contrast agent (n:96, 61.1%); air, contrast agent and debris (n:42, 26.7%) in most cases. Colonic diverticula (n:36, 22.9%), cholelithiasis (n:32, 20.4%), choledocholithiasis (n:7, 4.4%), and biliary dilatation (n:8, 5.1%) were the most common additional findings. Median follow-up time was 23 months (range 11 to 41 months). In three cases, new findings (cholelithiasis, n:3, choledocholithiasis, n:1) were detected.
Accompanying pathologies with DD diagnosis are valuable for physicians in order to manage the patients. Following clinical and radiological features of well-diagnosed DD might reduce the possible complications.
通过多排螺旋计算机断层扫描(MDCT)展示十二指肠憩室(DD)的患病率、伴随病变、影像学及随访结果。
对连续的2910例腹部MDCT进行回顾性分析,观察轴位、冠状位和矢状位图像。分别评估DD的患病率、位置、数量、大小、内容物、憩室颈部、伴随的胰胆病变、空肠憩室和结肠憩室。
157例(5.4%)诊断为DD,主要位于十二指肠第二部。壶腹周围DD最常见(78.3%),大多位于 Vater壶腹前方(n = 86,69.9%)。123例(78.3%)患者的DD为单发,34例(21.7%)患者的DD为多发。DD长轴的中位直径为2.5 cm(范围1.5 - 3.6 cm)。大多数情况下,DD腔内含有空气和造影剂(n = 96,61.1%);空气、造影剂和碎屑(n = 42,26.7%)。最常见的其他发现包括结肠憩室(n = 36,22.9%)、胆石症(n = 32,20.4%)、胆总管结石(n = 7,4.4%)和胆管扩张(n = 8,5.1%)。中位随访时间为23个月(范围11至41个月)。3例发现新病变(胆石症,n = 3;胆总管结石,n = 1)。
DD诊断时的伴随病变对医生治疗患者很有价值。了解诊断明确的DD的临床和影像学特征可能会减少潜在并发症。