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目的分析肠道脂肪瘤继发肠套叠的多层螺旋CT(MSCT)和X线表现,以提高对该病的认识和诊断水平。方法回顾性分析经手术病理证实的7例肠道脂肪瘤继发肠套叠患者的临床及影像学资料。7例均行腹部平片、MSCT平扫及增强扫描,其中2例行胃肠道造影检查。结果肿瘤位于空肠3例;结肠4例,其中乙状结肠3例,肝曲1例。MSCT均显示肠套叠及其顶端的肿瘤,套叠长度8～69 cm(平均31.43 cm);肿瘤长径2.74～9.89cm(平均5.81 cm),6例呈卵圆形或圆形,1例呈分叶状;肿瘤CT值为-43～-93 HU(平均-73.14 HU),4例呈均匀脂肪密度,3例密度不均,增强扫描均无强化。腹部平片4例显示不全性肠梗阻,3例无阳性发现。2例胃肠道造影均发现肠套叠及其顶端的充盈缺损。结论肠道脂肪瘤继发肠套叠的CT表现具有一定特征性,MSCT曲面重组(curved planar reformation,CPR)可充分展现肠套叠及其顶端肿瘤的全貌,有助于临床制定合理的治疗方案。
Objective To analyze the results of multislice spiral CT (MSCT) and radiological manifestations of intestinal lipomas secondary to intussusception to improve the level of awareness and diagnosis of the disease. Methods The clinical and imaging data of 7 patients with intestinal intustrectomy confirmed by surgery and pathology were retrospectively analyzed. Seven patients underwent plain radiography, MSCT plain scan and enhanced scan, of which 2 patients underwent gastrointestinal angiography. Results The tumors were located in jejunum in 3 cases and colon in 4 cases, including 3 sigmoid colon and 1 hepatic flexure. MSCT showed intussusception and the top of the tumor, the length of telescope 8 ~ 69 cm (average 31.43 cm); tumor length 2.74 ~ 9.89 cm (average 5.81 cm), 6 were oval or round, 1 case The tumor CT value was -43 ~ -93 HU (average -73.14 HU), 4 cases were uniform fat density, 3 cases of uneven density, no enhanced enhancement scan. 4 cases of abdominal plain film showed incomplete intestinal obstruction, 3 cases found no positive. 2 cases of gastrointestinal imaging were found in intussusception and filling the top of the defect. Conclusions The CT findings of secondary enterostoma of intestinal lipoma have certain characteristics. The curved planar reformation (CPR) of MSCT can fully display the complete picture of the intussusception and its top tumor, and help to make a reasonable clinical treatment plan .