Wu Shuang, Yu Huizhen, Liu Ying, Zhou Hong, Zhou Yang
Department of Medical Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.
Front Oncol. 2024 Jun 19;14:1288041. doi: 10.3389/fonc.2024.1288041. eCollection 2024.
Small Bowel Adenocarcinoma (SBA) is rare, occult and life-threatening malignancy in digestive system. Given low incidence and nonspecific symptoms, SBA is frequently detected in later stages. Double contrast enhanced ultrasound (DCEUS) is an innovative imaging technique applied to visualize the gastrointestinal tract, merging intravenous contrast-enhanced ultrasound with oral contrast-enhanced ultrasound. In this case, DCEUS was utilized and successfully detected an SBA of the jejunum.
A Chinese woman, aged 64, sought consultation in the gastroenterology department at our hospital, reporting symptoms of abdominal pain. Three months before entering the hospital, she underwent gastroscopy and colonoscopy which suggested chronic gastritis, and she was treated with oral drugs. However, her symptoms were not relieved, and even worsened. To further investigate, DCEUS was performed. The oral contrast agent dilated the luminal space of the upper gastrointestinal tract, resolving the hindrance caused by gas in the gastrointestinal tract and creating an acoustic window for scanning. Through this acoustic window, oral agent contrast-enhanced ultrasound (OA-CEUS) revealed a localized thickening of jejunal intestinal wall measuring 4x3 cm. Following intravenous injection of ultrasound contrast agent, the jejunal lesion exhibited faster enhancement and heterogeneous hyper-enhancement. Finally, the patient underwent jejunal tumor resection. Pathological examination revealed a jejunal adenocarcinoma.
The timely diagnosis of SBA can be challenging. DCEUS may have the potential to contribute to diagnosis and detailed evaluation of SBA, particularly in cases involving jejunum. Further researches are needed to fully explore the benefits of DCEUS in the standard diagnostic approach for small bowel diseases.
小肠腺癌（SBA）是消化系统中一种罕见、隐匿且危及生命的恶性肿瘤。由于发病率低且症状不具特异性，SBA常于疾病晚期才被发现。双对比增强超声（DCEUS）是一种用于可视化胃肠道的创新成像技术，它将静脉注射造影剂增强超声与口服造影剂增强超声相结合。在本病例中，DCEUS被用于并成功检测出一例空肠SBA。
一名64岁中国女性因腹痛症状前来我院消化内科就诊。入院前三个月，她接受了胃镜和结肠镜检查，结果提示慢性胃炎，随后接受口服药物治疗。然而，她的症状并未缓解，甚至有所加重。为进一步检查，进行了DCEUS检查。口服造影剂使上消化道管腔空间扩张，消除了胃肠道内气体造成的干扰，并为扫描创造了一个声学窗口。通过这个声学窗口，口服造影剂增强超声（OA-CEUS）显示空肠肠壁局限性增厚，大小为4×3厘米。静脉注射超声造影剂后，空肠病变表现出更快的增强和不均匀高增强。最终，患者接受了空肠肿瘤切除术。病理检查显示为空肠腺癌。
SBA的及时诊断可能具有挑战性。DCEUS可能有助于SBA的诊断和详细评估，尤其是在涉及空肠的病例中。需要进一步研究以充分探索DCEUS在小肠疾病标准诊断方法中的益处。
