Research and analysis on computed tomography signs and clinical characteristics of chronic duodenal papilla mucositis and duodenal papillary carcinoma

Abstract

Objective: To investigate the computed tomography (CT) findings of chronic duodenal papilla mucositis and duodenal papillary carcinoma, and provide more imaging information for early diagnosis of duodenal malignant diseases. Methods: CT findings and clinical data of 40 patients with chronic duodenal papilla mucositis and 46 patients with duodenal papillary carcinoma were retrospectively analyzed. Observation and measuring of direct duodenal papilla signs (including size, shape, density, enhancement uniformity, etc.), indirect duodenal papilla signs (including pancreaticobiliary dilatation) and clinical indicators (including tumor markers CA19-9, CA125, CEA, blood routine white blood cell count, bilirubin, age, gender, etc.) were carried out according to CT as well as statistical analysis. Results: There were significant differences in duodenal papilla regular morphology, age and CA19-9 ( p < .05), and significant differences in duodenal papilla maximum transverse diameter, diameter of common bile duct, diameter of pancreatic duct, total bilirubin, direct bilirubin, and jaundice in duodenal papillary carcinoma group ( p < 0.01). There were no significant differences in duodenal papilla enhancement uniformity, plain CT value, arterial CT value, portal CT value, enhancement uniformity, presence or not of calculus at the lower end, gender, CEA, CA125, white blood cell count, and abdominal pain with fever (all p > .05). Conclusion: CT is helpful for the diagnosis of duodenal papilla disease, but the CT findings of patients with duodenal papillary carcinoma tend to be similar to findings of chronic duodenal papilla mucositis, which is easy to lead to misdiagnosis, so comprehensive diagnosis should be made according to the direct and indirect CT signs as well as laboratory and clinical manifestations of duodenal papilla, so as to improve the diagnosis of duodenal papillary carcinoma, and reduce missed diagnosis and misdiagnosis.