| Objective: To summarize MSCT manifestations and energy spectrum curve characte-ristics of normal small bowel with orally administered isosmotic mannitol,provide reference standards for diagnosis of the small bowel diseases.Methods: Collect 31 cases with clinically diagnosed non-digestive diseases during February 2015 to December 2016,male 17,female 14 cases.All cases with orally administered isosmotic mannitol underwent abdominal MSCT enhanced scan,including six cases undergoing dual-source CT dualenergyscanning,we divided the subjects into three groups,including duodenum,jejunum and ileum.Observe and analyze bowel wall thickness,diameter of filling bowel,bowel wall delami nation,plain CT values and enhanced CT values,the number of the plica,mesen teric fa-t density,and 40-160 ke V single energy CT value.the mean+standard devi ation t-o the determination results,Oneway ANOVA was used to analyze the ind exes of small intestinein each group.The variance was consistent with the On eway ANOVA test and LSD was used.When the variance was inconsistent,Br own-F-orsythe was used for multiple comparisons with Tamhane test,P <0.05Statisti-cally significant.Results:1.The average bowel thickness was(2.00±0.16)mm.The average duodenum thickness was(2.01±0.17)mm.The average jejunum thickness was(2.00±0.15)mm.The average ileum thickness was(1.99±0.15)mm.The thickness of small bowel wall among different parts of the bowel were not significantly diff erent.2.The average diameter of filling bowel was(23.24±3.23)mm.The average dia meter of duodenum was(25.31±3.03)mm.The average diameter of jejunuml was(23.53±2.33)mm.The average diameter of ileum was(20.89±2.62)mm.Difference was statistically significant among each paragraph.3.The bowel presented single layer mostly,only 6.5%of the duodenum appear statified phenomenon.4.The CT values of small bowel in plain scan among different segments were not significant difference.The most prominent enhancement was observed in portal venous phase,and the CT values among different segments of the small bowel were also significantly different in the same phase of dynamic enhanced scan.CT value in different segments of the small bowel is gradually reducing from near to far.5.The average density of normal mesenteric fat was -96.11 HU,standard deviatio ns is 14.35 HU.The minimum is -131 HU.The maximum is -67 HU.6.There was no significant difference in the CT value of the normal small intes-tine among 40-160 ke V.In the arterial phase of 40-100 ke V normal small intestine between the groups were statistically significant,110-160 ke V the normal small intestine CT value of each group were no statistically significant difference.There was no significant difference in the single energy CT values between the three groups in the normal small intestine at 40-80 ke V.There was no significant difference in the single energy CT value between 80-160 ke V.Conclusion: Correct understanding of normal small intestine CTE performance and energy spectrum characteristics contribute to the diagnosis of small bowel disease.Objective: To explore the clinical value of CT enterography combined with Spectral imaging in the diagnosis of common small bowel malignant tumors.Methods: Collect 51 cases with small intestine tumors confirmed by operation and pathology in our hospital during February 2015 to December 2016.Observed and analyzed the frequency of the CTE imaging of the three groups of patients and the spectrum characteristics of the case,including the common age of the small intestine(adenocarcinoma,stromal tumor and lymphoma),the incidence of disease,the location,size,growth mode,,Strengthen the way,adjacent areas of lymph nodes and other swelling.Results:1.The group of 29 cases of stromal tumors,located in the duodenum in 8 cases,jejunum in 12 cases,9 cases of ileum,6.90%(2/29)by pathological diagnosis of very low risk,37.93%(11/29)low risk,6.90%(2/29)were moderate risk,48.28%(14/29)were highly dangerous.Statistical analysis showed that the difference of the morphology,maximal diameter,density,border,blood vessel and metastasis was statistically significant,but there was no significant difference in the degree of enhancement.The results of this study showed that the CT imaging findings of small intestine were correlated with the risk level of stromal tumor.The results of this study show that These signs including the largest diameter of the tumor> 5cm,unclear boundaries,uneven density,enhanced scan moderate to significant uneven enhancement highly suggest high risk stromal tumors.2.13 cases of adenocarcinoma,of which 6 cases were located in the ileum,4 cases of duodenum,3 cases of jejunum.8 cases showed thickening of the intestinal ring,stiff wall,5 cases of soft tissue mass in the intestine.9 cases of unclear boundary,4 cases of clear boundary.8 cases of uniform density,5 cases of uneven density,of which 2 cases can be seen liquefaction Necrosis.The lesions were significantly enhanced.The group of 4 cases can be seen mesenteric root or retroperitoneal lymph nodes,1 case of liver metastasis.3.9 cases of lymphoma,including 7 cases of ileum,duodenum in 2 cases.6 cases showed a small intestinal wall uneven thickening,the lesion involving a wide range,of which 5 cases of intestinal lesions were aneurysm-like expansion.3 cases of polypoid soft tissue mass shadow,of which 1 case with intussusception.CT scan showed 7 cases of uniform density,2 cases of uneven density,enhanced lesions were mild to moderate delay enhancement.5 cases with peripheral lymph nodes,of which 3 cases can be seen "hamburger sign".4.Common small intestine tumor enhancement CT value and spectrum characteristics:This study shows that small intestinal lymphoma enhancement curve was "platform" type change,interstitial tumor mostly "fast forward slow" type,adenocarcinoma was "fast forward fast out " type.This study showed that the difference between the three groups was statistically significant at 40-60 ke V adenocarcinoma,lymphoma and stromal tumors,and the single-energy CT values of adenocarcinoma and stromal tumors were greater than those of lymphoma,and in 70-160 ke V There was no significant difference in single-energy CT values between the two groups.The results of the two tests showed no statistically significant differences in adenocarcinoma and stromal tumors in single-energy CT values of 40-60 ke V in the venous phase.Conclusion:CT enterography can reflect the morphological characteristics of small intestine tumors,energy spectrum can provide a quantitative analysis of the tumor.CT enterography combined with energy spectrum characteristics for the diagnosis of small intestine tumors providing a new way of thinking and methods,have a high clinical value. |
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