摘要
目的:探讨十二指肠Brunner腺瘤(BGA)的CT表现,以提高对该病的认识和诊断水平。方法:收集中山大学附属第一医院2010年8月至2023年12月经手术及病理证实的10例BGA患者(均行CT增强检查及内镜检查)资料;同时,在中国知网和PubMed数据库中检索2000-2023年发表的关于BGA的文献,按照纳排标准获取可进行资料分析的文献20篇(20例BGA)。对全部30例(本组10例,文献20例)病例进行CT征象分析。结果:30例均为单发病灶,病灶基底部均位于胃窦部与十二指肠水平段之间,其中位于球部或球降交界区25例(83%),位于十二指肠降段2例(7%),位于十二指肠水平段2例(7%),位于胃窦部1例(3%)。26例(87%)病灶呈窄蒂长息肉状,4例(13%)呈宽基底结节状。25例(83%) CT增强检查呈不均匀强化,5例(17%)呈均匀强化。9例(30%)瘤内可见脂肪样密度;CT增强检查24例(80%)病灶表面可见强化的黏膜,重组正交断面上呈现“肠套叠假象”。病理镜下均可见增生的Brunner腺体及不同程度增生的腺管、脂肪细胞、梭形纤维细胞及平滑肌细胞。结论:BGA发病部位相对恒定,CT表现有一定特征性,有助于术前正确诊断。
Purpose:To investigate the CT manifestations of Brunner's gland adenoma of the duodenum(BGA)and to improve its recognition and diagnostic accuracy.Methods:Ten cases of BGA confirmed by surgery and pathology from August 2010 to December 2023 at the First Affiliated Hospital of Sun Yat-sen University were collected,and all cases underwent contrast CT scan and endoscopy.Meanwhile,the literatures related to BGA published between 2000 and 2023 were searched in the China National Knowledge Infrastructure and PubMed databases,and 20 articles(20 cases of BGA)that could be analyzed were extracted according to the inclusion and exclusion criteria.The CT features of all 30 cases(our 10 cases and 20 published cases)were analyzed.Results:All cases involved a single lesion,and the basal parts of all lesions were located between the gastric antrum and the horizontal part of duodenum,with the location at the duodenal bulb and bulb/descending junction in 25 cases(83%),the descending part of duodenum in 2 cases(7%),the horizontal part of duodenum in 2 cases(7%),and the gastric antrum in 1 case(3%).Long polyp-like lesion with a narrow pedicle was presented in 26 cases(87%),and nodular lesion with a wide base in 4 cases(13%).Uneven density on the contrast CT scan was detected in 25 cases(83%),and uniform density in 5 cases(17%).Adipose density was visible in the lesion in 9 cases(30%).Enhanced mucosa was visible on the surface of the lesion in 24 cases(80%),and the"intussusception illusion"was observed on the reconstructed orthogonal sections.Histopathological examination of the specimen showed hyperplastic Brunner's glands and varying degrees of hyperplastic glandular duct,adipocytes,fusiform fibrocytes,and smooth muscle cells.Conclusion:The location of BGA is relatively constant and the CT features are characteristic,which are helpful for correctpreoperative diagnosis.
作者
刘君
麻舒琳
云惟健
伍玲
李畅
关键
LIU Jun;MA Shulin;YUN Weijian;WU Ling;LI Chang;GUAN Jian(Department of Medical Imaging,Kiang Wu Hospital;Department of Medical Imaging,The First Affiliated Hospital,Sun Yat-sen University)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2024年第5期583-588,共6页
Chinese Computed Medical Imaging
