CAJ | 학술논문

目的探讨新生儿环状胰腺的MSCT表现及诊断价值.方法回顾性分析27例经手术证实的新生儿环状胰腺临床及CT资料,其中20例行CT平扫及增强检查.2名高年资医师分析阅片,确定十二指肠梗阻部位及梗阻程度、胰头与梗阻端关系及周围组织结构的变化.结果直接征象:CT显示胰头部中间含气或对比剂肠管影4例；增强后17例十二指肠降部周围软组织与正常胰腺组织强化一致,梗阻端肠壁与环状胰腺间脂肪间隙消失17例.间接征象:20例显示十二指肠梗阻,其中“单泡征”2例,“双泡征”18例,18例“双泡征”中12例十二指肠泡直径(Dd)/胃泡直径(Ds)＞1.0;5例远端肠管无充气,15例远端肠管少量充气；梗阻部位:20例梗阻部均位于十二指肠降部；梗阻部形态:“乳头征”15例,“鼠尾征”5例；合并其他畸形:胰头中含气肠管异常扩张1例,胰管内积气1例,“漩涡征”2例.结论 MSCT结合三维重组技术可以清楚显示环状胰腺形态、判定梗阻部位和程度及发现其他并发畸形,为指导临床治疗方案的选择提供重要依据.
목적 탐토신생인배상이선적MSCT표현급진단개치.방법 회고성분석27례경수술증실적신생인배상이선림상급CT자료,기중20례행CT평소급증강검사.2명고년자의사분석열편,학정십이지장경조부위급경조정도、이두여경조단관계급주위조직결구적변화.결과 직접정상:CT현시이두부중간함기혹대비제장관영4례；증강후17례십이지장강부주위연조직여정상이선조직강화일치,경조단장벽여배상이선간지방간극소실17례.간접정상:20례현시십이지장경조,기중“단포정”2례,“쌍포정”18례,18례“쌍포정”중12례십이지장포직경(Dd)/위포직경(Ds)＞1.0;5례원단장관무충기,15례원단장관소량충기；경조부위:20례경조부균위우십이지장강부；경조부형태:“유두정”15례,“서미정”5례；합병기타기형:이두중함기장관이상확장1례,이관내적기1례,“선와정”2례.결론 MSCT결합삼유중조기술가이청초현시배상이선형태、판정경조부위화정도급발현기타병발기형,위지도림상치료방안적선택제공중요의거.
Objective To investigate the MSCT manifestations and their values in the diagnosis of annular pancreas in neonates.Methods Retrospective analysis of clinical and CT findings in 27 cases with surgery-proved annular pancreas in neonates was made.The unenhanced and contrast-enhanced CT images were obtained in 20 patients.Two experienced radiologists determined the site and degree of obstruction,the relationship between the head of the pancreas and the obstruction point,and the surrounding tissue structure.Results The direct signs included the fluid-filled or gas-filled bowel in the head of pancreas in 4 cases,the enhancement of surrounding soft tissue as enhanced pancreas in 17 cases,disappearance of the fat gap between the intestinal wall and the annular pancreas in 17 cases.The indirect signs included intestinal obstruction in 20 cases," single-bubble sign" in 2 cases," double-bubble sign" in 18 cases,the distal bowel without gas in 5 cases,small amount of gas in the distal bowel in 15 cases.In 12 of 18 cases showing "double-bubble sign",the ratio of duodenal bubble diameter(Dd) to stomach bubble diameter (Ds)was over 1.0.The site of obstruction was located in the descending duodenum in 20 cases.The form of obstructed point presented with "nipple sign" in 15 cases,with "the mouse tail" in 5 cases.The expansion bowel was located in the head of pancreas in 1 case.Gas was found in the pancreatic duct in 1 case,and "swirl sign" was shown in 2 cases.Conclusions MSCT combined with three-dimensional reconstruction techniques can clearly demonstrate the annular pancreas' s shape,the site and degree of obstruction and other malformations.It can provide important information for clinical treatment.