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題名 | Total Colonic Aganglionosis: Reappraisal of Contrast Enema Study=全結腸型先天性巨結腸症:重新評估灌腸攝影之影像表現 |
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作者 | 沈鼎文; 王超然; 勞允澤; 林瑞瑩; 賴勁堯; 張北葉; Sheng, Ting-wen; Wang, Chao-jan; Lo, Wan-chak; Lien, Rey-in; Lai, Jin-yao; Chang, Pei-yeh; |
期刊 | Journal of Radiological Science |
出版日期 | 20120300 |
卷期 | 37:1 2012.03[民101.03] |
頁次 | 頁11-19+54 |
分類號 | 416.245 |
語文 | eng |
關鍵詞 | 全結腸型先天性巨結腸症; 灌腸攝影; 影像表現; |
英文摘要 | Total colonic aganglionosis (TCA) is a rare form of Hirschsprung disease (HD). It is difficult to be diagnosed on contrast enema because the radiographic findings are variable. The study aims to re-evaluate the contrast enema findings of TCA. From 2001 to 2009, 14 patients (11 males, 3 females; ages from 1 day to 6 months) with pathologically proven TCA were reviewed for demographic features, clinical presentations, pathology reports, radiographic and contrast enema findings. In addition, the radiographic and contrast enema findings of 53 patients with non-TCA HD were reviewed and compared with those of TCA. Among the imaging findings, a short and rigid colon, small bowel dilatation, microcolon, and radiographic transition zone proximal to the cecum were statistically more significant in patients with TCA than in patients with non-TCA HD (P < 0.001). In conclusion, TCA is a colon disease presenting as small bowel obstruction clinically and radiographically. Although the radiographic findings of TCA are variable, TCA could be suspected when the initial radiograph shows small bowel dilatation and contrast enema shows a short and rigid colon, radiographic transition zone proximal to the cecum, poor rectal distensibility, colonic wall irregularity and delayed contrast emptying. In addition, biopsy should be performed to make a definite diagnosis. According to the caliber of the colon on contrast enema, a subgrouping approach may be useful in the differential diagnosis and be helpful in early diagnosis and exclusion of TCA. |
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