[1]刘天柱,彭振鹏,黄乐生,等.多排螺旋CT对胃肠道内可疑异位胰腺病灶的影像学诊断[J].中国医学物理学杂志,2020,37(3):317-321.[doi:DOI:10.3969/j.issn.1005-202X.2020.03.012]
　LIU Tianzhu,PENG Zhenpeng,HUANG Lesheng,et al.Imaging diagnosis of suspected heterotopic pancreatic lesions in the gastrointestinal tract by multi-slice spiral CT[J].Chinese Journal of Medical Physics,2020,37(3):317-321.[doi:DOI:10.3969/j.issn.1005-202X.2020.03.012]
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多排螺旋CT对胃肠道内可疑异位胰腺病灶的影像学诊断()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
37
期数:
2020年第3期
页码:
317-321
栏目:
医学影像物理
出版日期:
2020-03-25

文章信息/Info

Title:
Imaging diagnosis of suspected heterotopic pancreatic lesions in the gastrointestinal tract by multi-slice spiral CT
文章编号:
1005-202X（2020）03-0317-05
作者:
刘天柱1; 彭振鹏2; 黄乐生1; 张晚春1; 唐嘉慧1
1.广东省中医院珠海医院放射科， 广东 珠海 519000； 2.中山大学附属第一医院放射科， 广东 广州 510000
Author(s):
LIU Tianzhu1;  PENG Zhenpeng2;  HUANG Lesheng1;  ZHANG Wanchun1;  TANG Jiahui1
1. Department of Radiology, Zhuhai Hospital of Guangdong Hospital of Traditional Chinese Medicine, Zhuhai 519000, China; 2. Department of Radiology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510000, China
关键词:
异位胰腺; 多排螺旋CT; 影像诊断; 鉴别诊断; 胃肠道肿瘤
Keywords:
Keywords: heterotopic pancreas;  multi-slice spiral CT;  imaging diagnosis;  differential diagnosis;  gastrointestinal tumor
分类号:
R814.42
DOI:
DOI:10.3969/j.issn.1005-202X.2020.03.012
文献标志码:
A
摘要:
目的：探讨多层螺旋CT诊断胃肠道内异位胰腺的价值及对误诊病变进行分析。方法：对18例术前64排螺旋CT诊断为异位胰腺并获得病理结果的病例进行分组回顾分析。结果：收集到18例患者共19处病灶。诊断正确组有10例患者11处病灶，其中7处位于胃黏膜，3处位于十二指肠，1处位于回肠。以上病灶中5处可见“中央脐凹征”。诊断错误组有8例患者共8处病灶，3处位于胃黏膜或粘膜下，4处位于十二指肠内，1处位于食管下段内，病理结果提示8处病灶中3处为炎性病灶，2处为肿瘤病灶（胃肠间质瘤及神经内分泌肿瘤），1处为胃底腺异位，1处为胃粘膜脱垂，1处为Peutz-Jeghers息肉；其中胃底腺异位及间质瘤的影像表现上均有类似“中央脐凹征”表现。结论：通过64排多层螺旋CT扫描并收集到的病例中：（1）诊断正确组中大多数病灶位于胃及十二指肠；（2）诊断错误组中部分病灶表现为类似“中央脐凹征”，可能是导致误诊的原因之一；（3）误诊病例中炎性病变占比较大，认为胃肠道炎性病变需作为异位胰腺的鉴别诊断之一。
Abstract:
Abstract: Objective To explore the value of multi-slice spiral CT for the diagnosis of heterotopic pancreas in the gastrointestinal tract, and to analyze misdiagnosed lesions. Methods Eighteen cases diagnosed with heterotopic pancreas by 64-slice spiral CT before operation were enrolled in the study for a retrospective analysis, and their pathological results had been obtained. Results There were 19 lesions in the 18 patients. Eleven lesions were found in 10 patients in correct diagnosis group, including 7 lesions in the gastric mucosa, 3 lesions in the duodenum and 1 lesion in the ileum. The sign of central umbilication was observed in 5 of the above lesions. In misdiagnosis group, a total of 8 lesions were found in 8 patients, including 3 lesions in the gastric mucosa or submucosa, 4 leisons in the duodenum and 1 lesion in the lower esophagus. The pathological results indicated that 3 of the 8 lesions were inflammatory, and that there were 2 neoplastic lesions (gastrointestinal?stromal?tumor and neuroendocrine tumor), 1 heterotopia of gastric fundus gland, 1 gastric mucosal prolapse and 1 Peutz-Jeghers polyp. The imaging manifestations of heterotopias of gastric fundus gland and stromal tumor were similar to central umbilication. Conclusion The majority of lesions in correct diagnosis group are located in the stomach and duodenum. The manifestations of part of the lesions in misdiagnosed group are similar to central umbilication, which may be one of the causes of misdiagnosis. In addition, inflammatory lesions account for a large proportion of misdiagnosed cases, suggesting that gastrointestinal inflammatory lesions should be considered in the differential diagnosis of heterotopic pancreas.

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备注/Memo

备注/Memo:
【收稿日期】2019-10-17 【基金项目】珠海市卫生局科研基金（2018117A010062） 【作者简介】刘天柱，硕士，主治医师，研究方向：腹部放射诊断，E-mail: 153462964@qq.com
更新日期/Last Update: 2020-04-02