【摘要】 目的 探讨MRCP、TrueFISP结合3D-VIBE动态增强MR扫描在十二指肠恶性肿瘤诊断中的价值。方法 收集资料完整的原发性十二指肠恶性肿瘤29例，回顾性分析MR资料，观察病变发生部位、形态、信号特点、周围结构及有无远处转移。结果 本组腺癌共21例，黏液腺癌及印戒细胞癌混合1例，印戒细胞癌1例，神经内分泌癌1例，未分化癌1例，恶性间质瘤3例，1例霍奇金氏淋巴瘤。MR主要表现为十二指肠局部肠壁偏心性或环形不规则增厚，形成软组织结节或肿块，黏膜破坏消失，伴肠腔狭窄，均匀或不均匀持续强化。恶性间质瘤肿瘤较大，合并囊变坏死。淋巴瘤表现为肠壁弥漫增厚，合并腹膜后多发淋巴结肿大。7例侵犯胰头，7例合并淋巴结转移，5例合并肝转移。结论 MRCP、TrueFISP及3D-VIBE动态增强扫描结合对十二指肠恶性肿瘤诊断具有重要价值。肠壁不规则增厚并肿块形成、黏膜破坏消失是十二指肠恶性肿瘤的重要征象，病灶侵犯周围结构、合并淋巴结肿大或远处转移则有助于定性诊断。更多还原

【Abstract】 Objective To discuss the value of MRCP and TrueFISP combined with 3D-VIBE dynamic contrast-enhanced MRI in the diagnosis of malignant duodenal tumor.Methods 29 cases of primary malignant duodenal tumors with integrated data were collected, the MR data was retrospectively analysed, the tumors’ locations, shapes, signal features, surrounding structures and distant metastases were observed. Results Of the 29 patients, there were, in total, 21 adenocarcinomas, 1 mucinous adenocarcinoma and signet-ring cell mixed carcinoma, 1 signet-ring cell carcinoma, 1 neuroendocrine carcinoma, 1 anaplastic carcinoma, 3 malignant gastrointestinal stromal tumors and 1 Hodgkin lymphoma. Imaging signs were mainly included the following: duodenum wall thickening asymmetrically or symmetrically, accompanied with soft tissue masses or nodi, intestinal mucosa destruction and disappearance with intestinal stenosis, and continued homogeneous or inhomogeneous enhancement. Malignant gastrointestinal stromal tumor exhibited a massive mass, and was more likely to have an area of necrosis or cystic degeneration. Lymphoma showed extensive duodenal wall thickening and retroperitoneal lymph node enlargement. 7 cases had pancreatic head invasion; 7 cases showed lymphatic metastasis; 5 cases had hepatic metastasis.Conclusion MRCP and TrueFISP combined with 3D-VIBE dynamic contrast-enhanced scan have notable diagnostic value in primary malignant duodenal tumors. The signs of duodenum wall thickening along with soft tissue masses and intestinal mucosa destruction could be the most important hint for making diagnosis. The signs of surrounding structure invasion, lymphatic metastasis or distant metastases will help to confirm the diagnosis.更多还原