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目的 :探讨原发性十二指肠腺癌的影像表现及与手术切除相关征象。方法 :对照手术回顾性分析 17例经病理证实的十二指肠腺癌低张十二指肠造影 (hypotonicduodenography ,HD)和CT的表现。结果 :HD显示息肉型 9例 ,溃疡型 7例 ,浸润型 1例。CT均示腔内不规则肿块或肠壁增厚 ,3例示溃疡 ,胆系扩张 10例 ,胰头浸润 14例 ,血管浸润 7例 ,淋巴结转移 3例 ,肝转移 2例。 7例行根治术 ,10例行姑息术。结论 :HD与CT结合可充分显示腔内病变 ,腔外浸润及转移。癌肿局限于腔内或仅侵犯胰头时可行根治术 ;侵犯周围重要血管 ,发生淋巴结、肠系膜及肝脏等转移时一般只能行姑息术。
Objective: To investigate the imaging features of primary duodenal adenocarcinoma and related signs of surgical resection. Methods: Retrospective analysis of 17 cases of pathologically confirmed duodenal adenocarcinoma with hypotonic duodenum angiography (HD) and CT. Results: HD showed 9 cases of polypoid type, 7 cases of ulcer type, and 1 case of infiltrative type. CT showed irregular intraluminal masses or thickening of the intestinal wall, 3 cases showed ulcers, 10 cases of biliary dilatation, 14 cases of pancreatic head infiltration, 7 cases of vascular invasion, 3 cases of lymph node metastases, and 2 cases of liver metastases. Radical surgery was performed in 7 cases and palliative in 10 cases. Conclusion : The combination of HD and CT can fully show intraluminal lesions, extraluminal infiltration and metastasis. Cancer is limited to intraluminal or violating the pancreas only feasible radical surgery; violation of surrounding vital blood vessels, the occurrence of lymph node, mesentery and liver metastasis can only be palliated.