Department of Radiology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, PR China.
Department of Gastroenterology, Jiangmen Central Hospital, Affiliated Jiangmen Hospital of Sun Yat-Sen University, Jiangmen, Guangdong, PR China.
Acta Radiol. 2021 Dec;62(12):1567-1574. doi: 10.1177/0284185120973626. Epub 2020 Dec 3.
The etiologies of small bowel intussusception (SBI) in adults are varied.
To investigate multidetector computed tomography (MDCT) characteristics in adults with neoplastic and non-neoplastic SBI.
Clinical data and MDCT images diagnosed with SBI in adults from January 2010 to May 2020 were retrospectively reviewed.
The study included a total of 71 patients. Forty-two patients had a combined total of 55 neoplastic intussusceptions, including 29 patients with benign tumors and 13 patients with malignant tumors. Twenty-nine patients had a combined total of 36 non-neoplastic intussusceptions, of which the condition was idiopathic in 23 patients and cased by non-neoplastic benign lesions in six patients. There were no significant differences in patient age or sex ratio in the neoplastic and non-neoplastic groups. In the non-neoplastic group the intussusceptions were shorter in length (3.6 cm vs. 13.2 cm, <0.05) and smaller in transverse diameter (2.8 cm vs. 4.2 cm, <0.05), and less likely to be associated with intestinal obstruction (2 vs. 18, <0.05). The percentage of patients with multiple intussusceptions was greater in the neoplastic group (10/42, 23.8% vs. 4/29, 13.8%). In the non-neoplastic group only one lead point was detected (in a patient with Meckel's diverticulum), whereas lead points were detected in all 55 intussusceptions in the neoplastic group.
There are differences in the clinical and MDCT manifestations of adult neoplastic and non-neoplastic SBIs. Whether a lead point is present or not has implications with regard to deciding on the most appropriate treatment and avoiding unnecessary surgery.
成人小肠套叠（SBI）的病因多种多样。
探讨多排螺旋 CT（MDCT）在成人肿瘤性和非肿瘤性 SBI 中的表现特点。
回顾性分析 2010 年 1 月至 2020 年 5 月期间经 MDCT 诊断的成人 SBI 患者的临床资料和 MDCT 图像。
共纳入 71 例患者，其中 42 例患者共发生 55 次肿瘤性 SBI，包括 29 例良性肿瘤和 13 例恶性肿瘤；29 例患者共发生 36 次非肿瘤性 SBI，其中 23 例为特发性，6 例为非肿瘤性良性病变所致。肿瘤性和非肿瘤性 SBI 患者的年龄和性别比差异无统计学意义。非肿瘤性 SBI 肠套叠的长度（3.6cm 比 13.2cm，<0.05）和横径（2.8cm 比 4.2cm，<0.05）更短，更不易并发肠梗阻（2 例比 18 例，<0.05）。肿瘤性 SBI 患者的多发肠套叠比例更高（10/42，23.8%比 4/29，13.8%）。非肿瘤性 SBI 中仅 1 例存在肠套叠的肠管起始点（Meckel 憩室），而肿瘤性 SBI 组的 55 次肠套叠中均存在肠管起始点。
成人肿瘤性和非肿瘤性 SBI 的临床和 MDCT 表现存在差异。是否存在肠管起始点对决定最合适的治疗方案和避免不必要的手术具有重要意义。
