左上腹网膜囊区肿块病变的诊断初探(附97例报告)  

Diagnosis and analysis of occupying masses in the peritoneal sac area of left upper abdomen

作　　者：汪溪[1] 陈宽仁[1] 李建业[1] 卞正乾[2] 

机构地区：[1]江苏省连云港市第二人民医院普外科,江苏连云港222003 [2]上海交通大学医学院附属仁济医院普外科,上海200001

出　　处：《海南医学》2010年第2期29-31,41,共4页Hainan Medical Journal

摘　　要：目的探讨位于左上腹腔网膜囊占位病变的诊断及鉴别诊断。方法回顾性分析97例病理证实的网膜囊区占位性病变患者的临床和影像学资料,以胰腺层面作为参考层面,最大层面位置作为定位方法,并分析定性诊断要点及误诊原因。结果左上腹网膜囊区占位中,胃来源肿块41例;胰源性肿块23例;网膜囊内肿块18例;肠源性肿块11例;脾源性肿块4例。不同来源占位最大平面各不相同。术前误诊23例(24%),各组定位误诊率差异无统计学意义(P>0.05)。病例临床表现无特异性,肿瘤的密度和形态无特异性。结论左上腹网膜囊区肿块主要来源于胃底和胰尾的恶性肿瘤;病变最大层面的位置及周围脏器形态对定位有一定价值;病变误诊主要由定位误诊造成;术前定性诊断较难。Objective To study the diagnosis and differential diagnosis of occupying masses in the peritoneal sac space among stomach, spleen and pancreas in the left upper abdomen. Methods To study CT and clinical materials of 97 patients with occupying masses in the peritoneal sac space among stomach, spleen and pancreas confirmed by pathology retrospectively. During reading the CT films, first locating its site and then its final diagnosis, analyzed its misdiagnosis causes. Results The pancreas plain was regarded as reference plain during the locating the masses site. The central spot and maximum plain of the mass were different among different pathology types of the masses. 41 of 97 were originated from stomach, 23 from pancreas all located at the same position as pancreas, 4 cases were from spleen; 18 from peritoneal cavity, and 11 from intestines. 23 of 97（24% ） had been misdiag- nosed because of wrong positioning, and there was no significant difference in the misdiagnosis rate among different groups. Occupying lesions imaging had no role in the diagnosis and differential diagnosis. Conclusion CT is a primary method to locate and give qualitative diagnosis of the masses in the left upper abdomen. The main lesions in this area come from the gastric fundus and tail of pancreas. It is valuable to locate the maximum plain of the masses and the shape changed of organs nearby in the process of diagnosis. It is hard to determine the pathological characteristics of these lesions before operation.

关 键 词：左上腹 网膜囊 肿块 CT 诊断 

分 类 号：R572[医药卫生—消化系统]