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1、APatternApproachtotheAbnormalSmallBowel:ObservationsatMDCTandCTEnterography（2）胡娟2011-8-4早读片Keypoints：Thepatternofenhancement；Thelengthofinvolvement；Thedegreeofthickening；Whetherthethickeningissymmetricorasymmetric；locationofthelesionalongthecourseofthesmallbowel(proximalordist
2、al)；Locationofthelesioninthewallofthesmallbowel(mucosal,submucosal,orserosal)；Associatedabnormalitiesinthemesenteryandvessels.LengthofInvolvementPathologicconditionstendtocauseFocalinvolvement(≤5cm),Segmentalinvolvement(6–40cm),Diffuseinvolvement(>40cm).FocalInvolvementNeoplas
3、ms-Metastasis,adenocarcinoma,andGIST.Others:-endometriosis,small-boweldiverticulitis,foreign-bodyperforations,small-bowelulcersfromtheuseofnonsteroidalantiinflammatorydrugs,and,occasionally,granulomatousprocessessuchastuberculosisandCrohn’sdiseaseSegmentalInvolvement■Intramura
4、lhemorrhage■Crohn’sdisease■Lymphoma■Infectiousenteritis■Occasionally,intestinalischemiaparticularlywhenthecauseisSMAembolusorSMVthrombosisDiffuseInvolvement■Hypoalbuminemia■Low-flowintestinalischemia■ProximalSMAembolus■Vasculitis■Angioedema■Graft-versus-hostdisease■Infectiouse
5、nteritisDegreeofThickeningWhenthenormalsmallbowelisdistended,thewallmeasuresnogreaterthan2mm.Muralthickeningcanbestratifiedintothreecategories:mild(3–4mm),moderate(5–9mm),marked(≥10mm).MildThickening■Hypoalbuminemia,■Infectiousenteritis,■Occasionallyinpatientswithischemiadueto
6、lackofarterialinflowormildCrohn’sdiseaseModerateThickening■Crohn’sdisease,intestinalischemia,intramuralhemorrhage,angioedema,andvasculitis■Someneoplasticprocessessuchaslow-T-stageadenocarcinomaandsomelymphomascanalsoshowmoderatethickeningMarkedThickening■Lymphoma■Otherneoplasm
7、s,vasculitis,Crohn’sdisease,andintramuralhemorrhage■Mostcasesofsmall-bowelwallthickeningmeasuring>20mmaredueto-neoplasms-intramuralhemorrhageSymmetricVersus AsymmetricThickeningMostconditionsthatcausesymmetricthickeningalongthecircumferenceofthesmallbowelarebenign.Crohn’sdisea
8、seandothergranulomatousconditionssuchastuberculosismayoccasio
