MSCT增强扫描用于原发性实性小肠肿瘤诊断研究进展

doi:10.13491/j.issn.1004-714X.2023.01.016

中国辐射卫生

2023, Vol. 32

Issue (1): 75-80 DOI: 10.13491/j.issn.1004-714X.2023.01.016

综述

本期目录 | 过刊浏览 | 高级检索

MSCT增强扫描用于原发性实性小肠肿瘤诊断研究进展

陈盈秀^1,2, 刘浅浅^1,2, 姬慧君^1,2, 陈琪^1,2, 顾梦瑶^1,2, 李万湖²

1. 山东第一医科大学（山东省医学科学院）研究生院，山东济南 250117;
2. 山东省肿瘤防治研究院（山东省肿瘤医院）影像科，山东第一医科大学（山东省医学科学院），山东济南 250117

Advances in the diagnosis of primary solid small bowel tumors by contrast-enhanced multislice spiral CT

CHEN Yingxiu^1,2, LIU Qianqian^1,2, JI Huijun^1,2, CHEN Qi^1,2, GU Mengyao^1,2, LI Wanhu²

1. Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117 China;
2. Department of Medical Imaging, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250117 China

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (517 KB) HTML ( )
输出: BibTeX | EndNote (RIS)

摘要原发性小肠肿瘤是一类发病率较低的肿瘤，尤其大部分小肠肿瘤是实性成分为主，病变在多层螺旋CT(multi-slice spiral CT, MSCT) 平扫上通常很难发现、且表现类似，彼此难以鉴别。本文描述小肠实性或实性成分为主的肿瘤的MSCT增强扫描技术和影像学特征，包括对比剂的类型和使用方法。在MSCT增强扫描检查方法中，CT小肠造影的优点是可以确定肠壁病变的真实范围、可能的透壁范围、肠系膜受累程度、远处转移、有助于发现和识别小肠肿瘤的供血血管、评估相应并发症；已经成为诊断、评估和分期小肠实性或实性成分为主肿瘤的最佳无创性成像技术。CT纹理分析（CT texture analysis, CTTA）作为新的研究热点，为原发性实性成分为主小肠肿瘤正确诊断提供了可能性。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	陈盈秀
	刘浅浅
	姬慧君
	陈琪
	顾梦瑶
	李万湖

关键词 ：多层螺旋CT, 增强模式, 小肠肿瘤, 放射学/影像学

收稿日期: 2022-09-30

PACS:

R816

基金资助:山东省肿瘤医院临床研究培育项目（2020-19）；北京康盟慈善基金会伦琴影像科研专项（SD-202008-017）；中国红十字基金会医学赋能公益专项基金2022年领航菁英临床科研项目（XM_LHJY2022_05_29）联合资助

通讯作者: 李万湖,E-mail:lwhvzg@126.com E-mail: lwhvzg@126.com

作者简介: 陈盈秀（1995—），女，山东滕州人，山东第一医科大学在读硕士研究生，研究方向：肿瘤影像诊断的临床研究工作。E-mail：cyingxiu@126.com

引用本文:

陈盈秀, 刘浅浅, 姬慧君, 陈琪, 顾梦瑶, 李万湖. MSCT增强扫描用于原发性实性小肠肿瘤诊断研究进展[J]. 中国辐射卫生, 2023, 32(1): 75-80.
CHEN Yingxiu, LIU Qianqian, JI Huijun, CHEN Qi, GU Mengyao, LI Wanhu. Advances in the diagnosis of primary solid small bowel tumors by contrast-enhanced multislice spiral CT. Chinese Journal of Radiological Health, 2023, 32(1): 75-80.

链接本文:

http://www.zgfsws.com/CN/10.13491/j.issn.1004-714X.2023.01.016 或 http://www.zgfsws.com/CN/Y2023/V32/I1/75

[1] Volk N, Lacy B. Anatomy and physiology of the small bowel[J]. Gastrointest Endosc Clin N Am, 2017, 27(1): 1-13. DOI: 10.1016/j.giec.2016.08.001
[2] Siegel RL, Miller KD, Fuchs HE, et al. Cancer statistics, 2021[J]. CA:Cancer J Clin, 2021, 71(1): 7-33. DOI: 10.3322/caac.21654
[3] Minordi LM, Binda C, Scaldaferri F, et al. Primary neoplasms of the small bowel at CT: a pictorial essay for the clinician[J]. Eur Rev Med Pharmacol Sci, 2018, 22(3): 598-608. DOI: 10.26355/eurrev_201802_14281
[4] Jasti R, Carucci LR. Small bowel neoplasms: a pictorial review[J]. Radio Graphics, 2020, 40(4): 1020-1038. DOI: 10.1148/rg.2020200011
[5] Kim SW, Kim HC, Oh J, et al. Tumors of the jejunum and ileum: a pattern-based imaging approach on CT[J]. Abdom Radiol, 2019, 44(7): 2337-2345. DOI: 10.1007/s00261-019-01978-5
[6] Anzidei M, Napoli A, Zini C, et al. Malignant tumours of the small intestine: a review of histopathology, multidetector CT and MRI aspects[J]. Br J Radiol, 2011, 84(1004): 677-690. DOI: 10.1259/bjr/20673379
[7] Hughes J, Lee A, Fong J, et al. Leiomyoma: a rare cause of small bowel obstruction[J]. ANZ J Surg, 2020, 90(6): 1165-1168. DOI: 10.1111/ans.15698
[8] Gill SS, Heuman DM, Mihas AA. Small intestinal neoplasms[J]. J Clin Gastroenterol, 2001, 33(4): 267-282. DOI: 10.1097/00004836-200110000-00004
[9] Ramai D, Tan QT, Nigar S, et al. Ulcerated gastric leiomyoma causing massive upper gastrointestinal bleeding: a case report[J]. Mol Clin Oncol, 2018, 8(5): 671-674. DOI: 10.3892/mco.2018.1597
[10] Schindler R, Blomquist OA. Leiomyosarcoma of the stomach; its roentgenologic and gastroscopic diagnosis and its possible relation to pernicious anemia[J]. Surg Gynecol Obstet, 1946, 82: 239-252
[11] Sokhandon F, Al-Katib S, Bahoura L, et al. Multidetector CT enterography of focal small bowel lesions: a radiological–pathological correlation[J]. Abdom Radiol, 2017, 42(5): 1319-1341. DOI: 10.1007/s00261-016-1015-1
[12] Maguire A, Sheahan K. Primary small bowel adenomas and adenocarcinomas-recent advances[J]. Virchows Arch, 2018, 473(3): 265-273. DOI: 10.1007/s00428-018-2400-7
[13] Williamson JML, Williamson RCN. Small bowel tumors: pathology and management[J]. J Med Assoc Thai, 2014, 97(1): 126-137
[14] Rengo M, Picchia S, Laghi A. Small bowel MDCT[M]//Nikolaou K, Bamberg F, Laghi A, et al. Multislice CT. Cham: Springer, 2017: 619-639. DOI: 10.1007/174_2017_22.
[15] Williams EA, Bowman AW. Multimodality imaging of small bowel neoplasms[J]. Abdom Radiol, 2019, 44(6): 2089-2103. DOI: 10.1007/s00261-019-01955-y
[16] El-Menyar A, Mekkodathil A, Al-Thani H. Diagnosis and management of gastrointestinal stromal tumors: an up-to-date literature review[J]. J Cancer Res Ther, 2017, 13(6): 889-900. DOI: 10.4103/0973-1482.177499
[17] Aparicio T, Zaanan A, Mary F, et al. Small bowel adenocarcinoma[J]. Gastroenterol Clin North Am, 2016, 45(3): 447-457. DOI: 10.1016/j.gtc.2016.04.004
[18] Maldonado FJ, Sheedy SP, Iyer VR, et al. Reproducible imaging features of biologically aggressive gastrointestinal stromal tumors of the small bowel[J]. Abdom Radiol, 2018, 43(7): 1567-1574. DOI: 10.1007/s00261-017-1370-6
[19] Li J, Ye YJ, Wang J, et al. Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor[J]. Chin J Cancer Res, 2017, 29(4): 281-293. DOI: 10.21147/j.issn.1000-9604.2017.04.01
[20] 陈允志, 李文武. MSCT影像特征对胃肠道间质瘤危险度的预测价值[J]. 中国辐射卫生,2021,30(4):496-500. DOI: 10.13491/j.issn.1004-714X.2021.04.021
Chen YZ, Li WW. The predictive value of MSCT imaging features on the pathological risk of gastrointestinal stromal tumors[J]. Chin J Radiol Health, 2021, 30(4): 496-500. DOI: 10.13491/j.issn.1004-714X.2021.04.021
[21] 顾阳春, 薛海桥. 胃肠道间质瘤CT征象及临床病理学特征分析[J]. 肿瘤影像学,2022,31(3):290-295. DOI: 10.19732/j.cnki.2096-6210.2022.03.012
Gu YC, Xue HQ. CT signs and clinicopathological features of gastrointestinal stromal tumor[J]. Oncoradiology, 2022, 31(3): 290-295. DOI: 10.19732/j.cnki.2096-6210.2022.03.012
[22] Kim SW, Kim HC, Yang DM, et al. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging[J]. Clin Radiol, 2016, 71(2): e130-e142. DOI: 10.1016/j.crad.2015.10.025
[23] Inoue A, Ota S, Sato S, et al. Comparison of characteristic computed tomographic findings of gastrointestinal and non-gastrointestinal stromal tumors in the small intestine[J]. Abdom Radiol, 2019, 44(4): 1237-1245. DOI: 10.1007/s00261-018-1865-9
[24] Shinya T. Malignant small bowel neoplasms: a review of post-contrast multiphasic multidetector computed tomography[J]. J Med Invest, 2022, 69(1.2): 19-24. DOI: 10.2152/jmi.69.19
[25] Basturk O, Yang ZH, Tang LH, et al. The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms[J]. Am J Surg Pathol, 2015, 39(5): 683-690. DOI: 10.1097/PAS.0000000000000408
[26] Kim JS, Park SH, Hansel S, et al. Imaging and screening of cancer of the small bowel[J]. Radiol Clin North Am, 2017, 55(6): 1273-1291. DOI: 10.1016/j.rcl.2017.06.008
[27] Levy AD, Sobin LH. Gastrointestinal carcinoids: imaging features with clinicopathologic comparison[J]. RadioGraphics, 2007, 27(1): 237-257. DOI: 10.1148/rg.271065169
[28] Manguso N, Gangi A, Nissen N, et al. Long-term outcomes after elective versus emergency surgery for small bowel neuroendocrine tumors[J]. Am Surg, 2018, 84(10): 1570-1574. DOI: 10.1177/000313481808401006
[29] Pizzi M, Sabattini E, Parente P, et al. Gastrointestinal lymphoproliferative lesions: a practical diagnostic approach[J]. Pathologica, 2020, 112(3): 227-247. DOI: 10.32074/1591-951X-161
[30] Oka P, Sidhu R. Small bowel lymphoma: clinical update and challenges for the gastroenterologist[J]. Curr Opin Gastroenterol, 2022, 38(3): 270-278. DOI: 10.1097/MOG.0000000000000829
[31] Olszewska-Szopa M, Wróbel T. Gastrointestinal non-Hodgkin lymphomas[J]. Adv Clin Exp Med, 2019, 28(8): 1119-1124. DOI: 10.17219/acem/94068
[32] Thomas AS, Schwartz M, Quigley E. Gastrointestinal lymphoma: the new mimic[J]. BMJ Open Gastroenterol, 2019, 6(1): e000320. DOI: 10.1136/bmjgast-2019-000320
[33] Lewis RB, Mehrotra AK, Rodríguez P, et al. From the radiologic pathology archives: gastrointestinal lymphoma: radiologic and pathologic findings[J]. RadioGraphics, 2014, 34(7): 1934-1953. DOI: 10.1148/rg.347140148
[34] Kohri M, Tsukasaki K, Akuzawa Y, et al. Peripheral T-cell lymphoma with gastrointestinal involvement and indolent T-lymphoproliferative disorders of the gastrointestinal tract[J]. Leuk Res, 2020, 91: 106336. DOI: 10.1016/j.leukres.2020.106336
[35] 魏渭, 林伟, 胡小艳, 等. 原发性肠道淋巴瘤的多层螺旋CT表现[J]. 中国CT和MRI杂志,2022,20(7):158-160. DOI: 10.3969/j.issn.1672-5131.2022.07.053
Wei W, Lin W, Hu XY, et al. The multi-slice CT features of primary intestinal lymphoma[J]. Chin J CT MRI, 2022, 20(7): 158-160. DOI: 10.3969/j.issn.1672-5131.2022.07.053
[36] Horton KM, Fishman EK. Multidetector-row computed tomography and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis[J]. J Comput Assist Tomogr, 2004, 28(1): 106-116. DOI: 10.1097/00004728-200401000-00019
[37] Gelsomino F, Balsano R, De Lorenzo S, et al. Small bowel adenocarcinoma: from molecular insights to clinical management[J]. Curr Oncol, 2022, 29(2): 1223-1236. DOI: 10.3390/curroncol29020104
[38] Benson AB, Venook AP, Al-Hawary MM, et al. Small bowel adenocarcinoma, version 1.2020, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2019, 17(9): 1109-1133. DOI: 10.6004/jnccn.2019.0043
[39] Puccini A, Battaglin F, Lenz HJ. Management of advanced small bowel cancer[J]. Curr Treat Options Oncol, 2018, 19(12): 69. DOI: 10.1007/s11864-018-0592-3
[40] McLaughlin PD, Maher MM. Primary malignant diseases of the small intestine[J]. AJR Am J Roentgenol, 2013, 201(1): W9-W14. DOI: 10.2214/AJR.12.8492
[41] Gore RM, Mehta UK, Berlin JW, et al. Diagnosis and staging of small bowel tumours[J]. Cancer Imaging, 2006, 6(1): 209-212. DOI: 10.1102/1470-7330.2006.0031
[42] Zeh III H. Cancer of the small intestine[M]//DeVita VT Jr, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2005: 1035-1048.
[43] Lubner MG, Smith AD, Sandrasegaran K, et al. CT texture analysis: definitions, applications, biologic correlates, and challenges[J]. RadioGraphics, 2017, 37(5): 1483-1503. DOI: 10.1148/rg.2017170056
[44] Feng C, Lu FF, Shen YQ, et al. Tumor heterogeneity in gastrointestinal stromal tumors of the small bowel: volumetric CT texture analysis as a potential biomarker for risk stratification[J]. Cancer Imaging, 2018, 18(1): 46. DOI: 10.1186/s40644-018-0182-4
[45] Liu SL, Zhang CY, Liu RQ, et al. CT texture analysis for preoperative identification of lymphoma from other types of primary small bowel malignancies[J]. Biomed Res Int, 2021, 2021: 5519144. DOI: 10.1155/2021/5519144