CAJ | 학술논문

目的：探讨MSCT后重组技术在十二指肠降部憩室诊断中的临床应用价值。方法搜集经手术或内镜、上消化道钡餐造影证实的十二指肠降部憩室患者的MSCT检查资料17例，均行CT双期增强扫描，，扫描图像进行1.5mm薄层重组，Syngo Acquisition Workplace后处理工作站进行多平面重组（MPR）后处理观察。结果17个憩室直径为6.5~34.6mm，均位于十二指肠系膜缘，表现为紧贴十二指肠降部壁外的圆形或类圆形囊袋状影，8例囊内表现为气液平，6例仅为气体密度影，1例囊内为液体密度影，2例囊内为混合密度影表现为筛板状或网格状影；3例发生在十二指肠降部前壁，11例发生在十二指肠降部乳头旁表现为紧贴胰头右后方或后方囊袋状影，与胰头界限清晰；3例十二指肠乳头位于憩室内，并发胆管结石、肝内外胆管扩张、胰腺炎；运用MSCT后处理 MPR技术结合原始薄层轴位图像均能显示憩室颈部位置，原始轴位薄层图像结合多方位重组技术可明确显示憩室。本组病例中1例合并胆总管结石、胆总管扩张、胆囊结石、胆囊炎、急性胰腺炎患者的巨大憩室位于十二指肠降部后方，利用多平面重组（MPR）后处理发现憩室颈部位于十二指肠乳头区，乳头位于其内，为憩室内乳头型。本组病例17例中有14例发生在乳头旁或其内，发生率为82.4%；1例憩室表现为液体密度影，须鉴别于胰头囊性病灶，运用MPR后处理技术显示憩室颈可与之鉴别。运用 MSCT后处理技术MPR可从不同角度了解憩室与十二指肠乳头、胆总管的关系。结论MSCT以其安全无创、分辨率高的优点，原始薄层轴位图像结合后处理 MPR技术的运用，有助于对十二指肠降部憩室的诊断，明确憩室颈部的位置，判断十二指肠乳头旁憩室，同时可提供其并发症的诊断信息。
목적：탐토MSCT후중조기술재십이지장강부게실진단중적림상응용개치。방법수집경수술혹내경、상소화도패찬조영증실적십이지장강부게실환자적MSCT검사자료17례，균행CT쌍기증강소묘，，소묘도상진행1.5mm박층중조，Syngo Acquisition Workplace후처리공작참진행다평면중조（MPR）후처리관찰。결과17개게실직경위6.5~34.6mm，균위우십이지장계막연，표현위긴첩십이지장강부벽외적원형혹류원형낭대상영，8례낭내표현위기액평，6례부위기체밀도영，1례낭내위액체밀도영，2례낭내위혼합밀도영표현위사판상혹망격상영；3례발생재십이지장강부전벽，11례발생재십이지장강부유두방표현위긴첩이두우후방혹후방낭대상영，여이두계한청석；3례십이지장유두위우게실내，병발담관결석、간내외담관확장、이선염；운용MSCT후처리 MPR기술결합원시박층축위도상균능현시게실경부위치，원시축위박층도상결합다방위중조기술가명학현시게실。본조병례중1례합병담총관결석、담총관확장、담낭결석、담낭염、급성이선염환자적거대게실위우십이지장강부후방，이용다평면중조（MPR）후처리발현게실경부위우십이지장유두구，유두위우기내，위게실내유두형。본조병례17례중유14례발생재유두방혹기내，발생솔위82.4%；1례게실표현위액체밀도영，수감별우이두낭성병조，운용MPR후처리기술현시게실경가여지감별。운용 MSCT후처리기술MPR가종불동각도료해게실여십이지장유두、담총관적관계。결론MSCT이기안전무창、분변솔고적우점，원시박층축위도상결합후처리 MPR기술적운용，유조우대십이지장강부게실적진단，명학게실경부적위치，판단십이지장유두방게실，동시가제공기병발증적진단신식。
Objective to evaluate MSCT reconstruction after technical department on duodenal diverticulum diagnosis in the clinical application value. Methods to col ect confirmed by surgery or endoscopic, upper gastrointestinal barium meal of duodenal descending part diverticulum MSCT examination data of 17 cases of patients, are double phase CT enhanced scan, scan images to reorganize, 1.5 mm thin layer Syngo Acquisition Workplace post-processing workstation for post-treatment of multiple planar reconstruction (MPR) were observed. Results 17 diverticulum is 6.5~34.6 mm in diameter, which both are located in ten finger mesenteric marginal, is close to the ministry of duodenal descending wal round or class round pouch shape outside the shadow, 8 cases of pouch for gas and liquid flat, only 6 cases of gas density shadow, 1 case of pouch for liquid density, 2 cases of pouch as mixed density of sieve plate shape or grid shadow; 3 cases occurred in front of duodenal descending part wal , 11 cases occurred in duodenal descending part near the nipple is close to the right rear of the head of pancreas or pouch shape behind the shadow, and the pancreatic head clear boundaries;3 cases of duodenal papil a is within diverticulum complicated with bile duct calculi, expansion of bile duct of liver inside and outside, and pancreatitis;Using MSCT post-processing MPR technique combined with the original thin layer axial images can display diverticulum neck position, the original axis of a thin layer of recombinant technology combining multiple images can clearly show diverticulum. Incidence in 1 case with common bile duct calculi, common bile duct, gal bladder stones, cholecystitis, acute pancreatitis patients of giant diverticulum in duodenum drop behind, the multiple planar reconstruction (MPR) post-processing revealed diverticulum neck in duodenum nipple area, nipple located on the inside, inside the diverticulum for nipples. Incidence in 14 of 17 cases occurred in nipple or near them, the incidence is 82.4%; 1 case of diverticulum characterized by liquid density, shal identify in focal cystic pancreatic head, using MPR post-processing techniques diverticulum neck can identify with them. Using MSCT post-processing techniques MPR can understand from dif erent angles with duodenal diverticulum nipple, the relationship between bile duct. Conclusion MSCT with its safe and noninvasive, high resolution, the advantages of the original thin axis image post-processing MPR technology use, contribute to the diagnosis of duodenal descending of diverticulum, clear diverticulum neck position, judging by the duodenal papil a diverticulum, at the same time can provide the diagnosis information of complications.