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目的:探讨多层螺旋CT(MSCT)在黑斑息肉病(P-J)综合征中的应用价值及可行性。方法:回顾性选取29例临床诊断为P-J综合征患者资料,所有患者均行MSCT检查,口服低浓度阳性对比剂后行全腹部CT平扫,部分患者行增强检查。利用CT后处理软件进行三维重建,观察病变位置、形态及与周围组织器官的关系和腹腔内胃肠道外组织器官的情况。同期行肠镜检查或外科手术活检,所有结果均与病理结果进行对照分析。结果:MSCT发现28例患者胃肠道内多发结节,其中11例并发肠套叠;1例患者未见异常。29例患者经病理证实均符合P-J综合征,2例部分息肉为腺瘤样息肉,1例恶变;CT检出率为96.6%(28/29)。29例中CT发现有5例患者合并胃肠道外的肿瘤,3例仅并发卵巢粘液性囊腺瘤,1例同时并发卵巢粘液腺囊腺瘤和乳腺导管内乳头状瘤,1例息肉恶变为腺鳞癌伴肝内及腹腔多发淋巴结转移。结论:MSCT小肠造影是一种简便易行的检查方法,对P-J综合征病灶的定位、定性、鉴别诊断及随访具有较高的应用价值和可行性。
Objective: To investigate the value and feasibility of MSCT in P-J syndrome. Methods: The data of 29 patients with P-J syndrome were retrospectively selected. All patients underwent MSCT. After oral low-dose positive contrast agent, CT scan of the whole abdomen was performed. Some patients underwent enhanced examination. CT postprocessing software was used to reconstruct the three-dimensional reconstruction. The location and shape of the lesion, the relationship with the surrounding tissues and organs and the intra-abdominal extraintestinal tissues and organs were observed. Concurrent colonoscopy or surgical biopsy, all results were compared with the pathological results. Results: MSCT found multiple nodules in the gastrointestinal tract in 28 patients, of which 11 cases were complicated with intussusception. One patient had no abnormality. Twenty-nine patients were pathologically confirmed P-J syndrome. Two of the polyps were adenomatous polyps and one was malignant. The detection rate of CT was 96.6% (28/29). Among the 29 cases, CT was found in 5 cases of patients with gastrointestinal tract tumors, 3 cases of complicated with ovarian mucinous cystadenoma, 1 case of concurrent ovarian mucinous cystadenoma and intraductal papilloma, 1 cases of malignant polyps Adenosquamous carcinoma with multiple intrahepatic and abdominal lymph node metastases. Conclusion: MSCT small bowel angiography is an easy and convenient method of examination. It has high application value and feasibility in the localization, qualitative diagnosis, differential diagnosis and follow-up of P-J syndrome.