CT manifestations of duodenal bulbar ulcer / 中国医学影像技术

ABSTRACT

Objective: To observe CT manifestations of duodenal bulbar ulcer. Methods: Data of upper abdomen plain and enhanced CT of 44 patients with duodenal bulbar ulcer (ulcer group) and 51 patients without duodenal bulbar ulcer (control group) confirmed with gastroscopy were retrospectively analyzed. The wall thickness, enhancement degree (CT value difference between arterial phase or portal phase and plain scan [ΔCT arterialphase, ΔCT portalphase]), enhancement pattern, CT manifestations of mucosal surface and changes of peripheral fat space of duodenal bulbar intestinal were analyzed and compared between 2 groups. Then ROC curves of parameters statistically different between groups for diagnosis of ulcer were respectively drawn, and AUC was calculated to evaluate the relative diagnostic efficacy. Furthermore, the missed rate of CT diagnosis of ulcer group was calculated. Results: The wall thickness of duodenal bulbar in ulcer group ([7.52±2.30]mm) was greater than that in control group ([2.89±0.75]mm, t=12.76, P0.05). Layered enhancement, irregular mucosal surface and blurred fat space around duodenal bulbar were more common in ulcer group (χ2=56.12, 65.94, 45.71, all P<0.01). AUC of the wall thickness, enhancement pattern, CT findings of mucosal surface and changes of peripheral fat space of duodenal bulb in diagnosis of ulcer was 0.99, 0.90, 0.93 and 0.84, respectively. CT missed diagnosed 36 cases of duodenal bulbar ulcer, and the rate of missed diagnosis was 81.82%(36/44). Conclusion: Thickened duodenal bulb intestinal wall, layered enhancement pattern, irregular mucosal surface and blurred fat space around are typical CT manifestations of bulbous ulcer. Accurate recognition of CT manifestations of bulbous ulcer is helpful to reducing missed diagnosis.