CAJ | 학술논문

目的：分析消化道异位胰腺的多层螺旋CT(MDCT)表现，提高诊断的准确性和鉴别诊断能力。方法回顾性分析25例经组织病理学证实的消化道异位胰腺的MDCT资料，患者术前均行多排螺旋CT平扫、三期增强扫描及三维重建，观察病灶的位置、大小、长径与短径的比值、形态、密度、强化方式、强化程度、生长方式、病灶边界、病灶表面及周围粘膜情况，总结该病的CT表现特点。结果25例均为单发病灶，9例(36%)发生在胃部，9例(36%)在十二指肠，5例(20%)在空肠，2例(8%)在回肠；大小为6mm-25mm；胃病灶LD/SD>1.4的有7例(78%)；十二指肠病灶LD/SD>1.4的有5例(55%)；空回肠病灶LD/SD均为1.0。15例(60%)为类圆形，4例为圆形，4例呈不规则形，2例表现为胃肠壁局部增厚。11例(44%)起源于黏膜下及肌层，21例(84%)累及黏膜下层。病灶平扫密度均匀，增强扫描均呈持续性强化，类似胰腺强化方式；13例(53%)病灶强化程度与正常胰腺组织相仿；2例显示导管征；20例(80%)病灶向腔内生长，18例(72%)病灶边界欠清楚。结论消化道异位胰腺的CT表现具有一定特征性，熟悉其特点可提高对该病的诊断水平。
목적：분석소화도이위이선적다층라선CT(MDCT)표현，제고진단적준학성화감별진단능력。방법회고성분석25례경조직병이학증실적소화도이위이선적MDCT자료，환자술전균행다배라선CT평소、삼기증강소묘급삼유중건，관찰병조적위치、대소、장경여단경적비치、형태、밀도、강화방식、강화정도、생장방식、병조변계、병조표면급주위점막정황，총결해병적CT표현특점。결과25례균위단발병조，9례(36%)발생재위부，9례(36%)재십이지장，5례(20%)재공장，2례(8%)재회장；대소위6mm-25mm；위병조LD/SD>1.4적유7례(78%)；십이지장병조LD/SD>1.4적유5례(55%)；공회장병조LD/SD균위1.0。15례(60%)위류원형，4례위원형，4례정불규칙형，2례표현위위장벽국부증후。11례(44%)기원우점막하급기층，21례(84%)루급점막하층。병조평소밀도균균，증강소묘균정지속성강화，유사이선강화방식；13례(53%)병조강화정도여정상이선조직상방；2례현시도관정；20례(80%)병조향강내생장，18례(72%)병조변계흠청초。결론소화도이위이선적CT표현구유일정특정성，숙실기특점가제고대해병적진단수평。
Objective To analyze the multi-detector computed tomography (MDCT) features of ectopic pancreas in the gastrointestinal tract in order to improve the diagnostic accuracy of the disease. Methods CT findings were reviewed retrospectively in 25 cases with ectopic pancreas confirmed by surgery and pathology.All patients underwent plain CT, contrast-enhanced scanning with three phases and three dimensional reconstruction. Analyze the location, size, the long diameter (LD)/the short diameter(SD), shape, attenuation, contrast-enhancement pattern and grade of the lesions, growth pattern, border, as well as enhancement of the overlying mucosa. Results All 25 cases were of single lesion.9cases were in the gastric.9 cases were in the duodenum, 5 cases were in the jejunum, 2 cases were in the ileum. The max axes ranged from 6-25mm, 7 cases the LD/SD ratio is greater than 1.4 in gastric ectopic pancreas, 5 cases the LD/SD ratio is greater than 1.4 in duodenum. the LD/SD ratio of the jejunum and ileum lesion is 1.0. 15 cases were ovoid in shape, 4 cases were sphere, 4 cases were irregular shape, 2 cases were manifested as Localized thickening of the gastrointestinalwall. 11cases were located in the submucosa and muscularis.The ectopic pancreas was continuously enhanced in all cases,The contrast enhancement grade was similar to that of the normal pancreatic tissue in 13 cases. 2 case showed central duct sign. 20 cases were endoluminal growth pattern. Conclusion Gastrointestinal tract ectopic pancreas has certian MDCT charateristics. It can help us to improve the diagnostic ability of the disease to familiar with these features.