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小儿肠重复畸形的多层螺旋CT表现与临床 预览

Intestinal duplication in children: multi-slice CT features and clinical manifestation
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摘要 目的 探讨小儿肠重复畸形的CT表现和临床特征,提高对该病的认识和诊断水平。 方法 回顾性分析10例经手术病理证实的小儿肠重复畸形CT表现、临床和病理特征。 结果 5例因产前超声发现腹部囊性包块就诊,5例表现为呕吐、腹痛、腹胀、血便和发热。合并不完全性肠梗阻 3 例,肠闭锁1例,感染1例。10例病灶中,囊肿型4例,管状型6例。CT形态表现球形者3例,类圆形1例,管状形 6例。发病部位以回肠最常见(6/10)。10例均呈单发水样密度囊性病变,边界清楚,位于肠管系膜侧;9例囊壁较厚、与邻近正常肠管厚度相仿;1例囊内壁见褶皱样突起,1例囊内见分隔;增强扫描9例囊壁均呈轻中度强化,与邻近正常肠管相仿,1例动脉期可见“晕轮征”。3例病灶与邻近肠管并行,3例与主肠管相通。8例病灶与邻近肠管血供相同,由肠系膜动脉分支供血。 结论 小儿肠重复畸形以急性肠梗阻就诊常见,其CT表现具有一定特征性,通过增强检查结合CT多平面重组,术前能做出准确诊断。 Objective To investigate multi-slice CT (MSCT) features and clinical manifestation of intestinal duplication in children. Methods The CT findings, clinical and pathological features of 10 cases of intestinal duplication confirmed by surgical pathology were analyzed retrospectively. Results Abdominal cystic mass was observed by prenatal ultrasound in 5 cases. Vomiting, abdominal pain, abdominal distension, bloody stools and fever of different degrees were noted in the other 5 cases. Incomplete intestinal obstruction was accompanied in 3 cases, intestinal atresia in 1 case and infection in 1 case. Among the 10 cases, 4 cases were cystic type and 6 were tubular type. There were three different shapes, including the spherical in 3 cases, the round in 1 case and the tubular in 6 cases. Ileum was most commonly involved (6/10). On unenhanced CT scan, all cases presented as single low-density cystic lesion with clear boundary, located on the mesenteric side. 9 cases had thick capsule wall, similar to adjacent normal bowel. 1 case appeared fold-like protrusions in the capsule wall and 1 case showed intra capsular separation. The capsule wall of 9 cases presented slight to moderate enhancement in enhanced arterial phase, which was also similar to adjacent normal bowel. "Halo sign" was noted in 1 case. 3 cases were paralleled and another 3 cases communicated with adjacent intestine. 8 cases shared the same blood supply from the superior mesenteric artery with adjacent intestine. Conclusion Acute intestinal obstruction was commonly observed in children intestinal duplication. CT manifestations of intestinal duplication in children have some characteristics. Enhanced CT with multiplannar reconstruction (MPR) as well as a comprehensive analysis of imaging features will help to improve the preoperative diagnosis.
作者 江肖松 吴松鑫 黄育斌 谭昱 沈敏 龚舒 江魁明 JIANG Xiaosong, WU Songxin, HUANG Yubin, TAN Yu, SHEN Min, GONG Shu, JIANG Kuiming(Department of Radiology, Guangdong Women and Childrdren Hospital, Guangzhou 511400, P.R.China)
出处 《医学影像学杂志》 2018年第7期1160-1163,共4页 Journal of Medical Imaging
关键词 小儿 肠重复畸形 体层摄影术 X线计算机 临床 Children Intestinal duplication Tomography X-ray computed Clinical
作者简介 江肖松(1990-),女,山东威海人,医学硕士,住院医师,主要从事医学影像诊断工作;通信作者:江魁明 E-mail:kmjang64@sina.com
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