Lemmel 综合征的影像诊断价值

Diagnostic Value of Imaging in Lemmel Syndrome

摘要:

〔摘 要〕 目的：探讨 Lemmel 综合征的电子计算机断层扫描（CT）及磁共振成像（MRI）影像表现。 方法：收集 经内镜逆行性胰胆管造影术（ERCP）证实的 5 例 Lemmel 综合征患者，回顾分析其影像表现。 结果：5 例 Lemmel 综 合征患者中，病变均为壶腹周围憩室（PAD）引起梗阻性黄疸。CT 表现十二指肠降段憩室并见扩张，胆总管下端受 压，引起胆总管梗阻扩张，增强扫描显示憩室与十二指肠强化一致，憩室黏膜强化，憩室炎改变；磁共振胰胆管造影 （MRCP）可以清楚显示肝内外胆管扩张程度及胆总管与憩室的关系。 结论：Lemmel 综合征影像表现具有一定特征性， 对于梗阻性黄疸病因治疗至关重要。

Abstract:

〔Abstract〕 Objective To investigate the computed tomography (CT) and magnetic resonance imaging (MRI) findings of Lemmel syndrome. Methods Five patients with Lemmel syndrome confirmed by endoscopic retrograde cholangio pancreatography (ERCP) were collected, and the imaging findings were retrospectively analyzed. Results Among the 5 patients with Lemmel syndrome, the lesions were all obstructive jaundice caused by periampullary diverticula (PAD). CT showed diverticulum in descending segment of duodenum with dilatation, and the lower end of common bile duct was compressed, causing obstruction and dilation of common bile duct. Enhanced scan showed that diverticulum was consistent with duodenum enhancement, diverticulum mucosa was enhanced, and diverticulitis was changed; magnetic resonance cholangiopancreatography (MRCP) can clearly show the degree of intrahepatic and extrahepatic bile duct dilatation and the relationship between the common bile duct and diverticulum. Conclusion The imaging manifestations of Lemmel syndrome have certain characteristics, which are crucial for the etiological treatment of obstructive jaundice.