急性胰腺炎胰外蜂窝组织炎CT表现及其分布的解剖病理基础  

CT features of extra-pancreatic phlegmon in acute pancreatitis anatomic-pathological correlation

作　　者：姚沛旭[1] 许建生[1] 陈曙[1] 钟柱[1] 

机构地区：[1]广东省揭阳市人民医院CT室,广东揭阳522000

出　　处：《中国临床医学影像杂志》2009年第7期538-540,共3页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨急性胰腺炎(AP)胰外蜂窝组织炎的CT表现及其分布的相关解剖病理学基础。材料和方法:回顾性分析2000年12月～2008年10月经临床连续性治疗的126例合并胰外蜂窝组织炎AP病例,分析胰外蜂窝组织炎CT表现,并分析蜂窝组织炎的分布与解剖病理学的关系。结果:蜂窝组织炎CT表现为密度比腹水稍高的软组织密度块,CT值约5～30HU,形态不规则,边界模糊不清,增强扫描边缘部分轻度强化。126例AP共259处蜂窝组织灶,分布以小网膜囊(93次),左肾旁前间隙(69次),右、左侧结肠旁沟(26次和21次)常见,其次右肾旁前间隙12次,盆腔11次,肾旁后间隙、肾周间隙、左肝上间隙各次,左肝下间隙4次,右肝上间隙、左肠系膜窦、胸腔各2次,右肠系膜窦、心包各1次,多发67例。结论:AP胰外蜂窝组织炎的CT表现具特征性,其分布与腹腔解剖有一定关系,但由于蜂窝组织炎的侵袭性和流动性,解剖上不相通的部位也可受侵犯。Objective： To study the CT features of extra-pancreatic phlegmon in acute pancreatitis（AP） and the anatomicpathological bases of its distribution. Materials and Methods： The CT findings of 126 cases of AP proved by operation or clinical treatment were retrospectively analyzed. The CT features of the phlegmon out side of the organ and the anatomicpathological bases of its distribution were studied. Results： The CT findings of phlegmon appeared irregular soft tissue mass with CT value within 5-30HU, the marginal zone of the phlegmon appeared low-grade enhancement on enhanced scan. The distribution of phlegmon in 259 lesions more commonly appeared in lesser omental bursa （93 times）, left anterior pararenalspace （69 times）, right paracolonic groove （26 times） and left paracolonic groove （21 times）, others including right anterior pararenal-space 02 times）, pelvic cavity （11 times）, posterior pararenal space, perirenal space and left suprahepatic space（5 times） respectively, left subhepatic space（4 times）, right suprahepatic space, left mesentery sinus and thorax（2 times） respectively, right mesentery sinus and pericardiac 1 time respectively. Multiple lesions appeared in 67 cases. Conclusions： The CT findings of phlegmon out of the organ in AP were characteristic. The distribution of the phlegmon depended on the anatomic bases of the abdomen, but some compartment may be involved due to movement of the fluid and the devastating of the phlegmon.

关 键 词：胰腺炎 蜂窝织炎 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]