腹腔内巨大囊性占位性病变的CT诊断困境探讨  

Discussion on Difficulties of CT Diagnosis of Space Occupying Lesion of Huge Cyst in Abdominal Cavity

作　　者：王晓燕[1] 肖继伟[1] 

机构地区：[1]江汉大学附属医院放射影像科,湖北武汉430015

出　　处：《江汉大学学报（自然科学版）》2010年第2期96-100,共5页Journal of Jianghan University：Natural Science Edition

摘　　要：目的分析腹腔内巨大囊性占位性病变的CT表现,并重点探讨其在CT诊断方面的价值.病灶体积较大失去了原病灶的典型影像表现容易导致判断失误和误诊.方法搜集经手术病理证实的巨大囊性占位性病变共14例,其中腹腔内囊腺瘤8例,其中1例为超级巨大型;囊腺癌2例;子宫内膜异位囊肿2例;肠系膜囊肿2例.所有病例都经过平扫,部分经过平扫加增强扫描或三维重建.结果:14例病人都诊断为囊腺瘤,腹腔内囊腺瘤的正确诊断例数为8例,其中4例未做增强扫描,诊断困难,有2例误诊.结论:腹腔内巨大囊性占位性病变具有相似的CT特征,在病灶体积较大的情况下病灶失去了部分典型影像表现,从而对疾病的正确诊断带来一定的困难,尤其在定位定性诊断上经验不足,认识这些困难有助于掌握巨大囊性占位性病变在疾病发展中的一般规律.Objective：To analyze CT presentation of space occupying lesion of huge cyst in abdominal cavity,and emphasize on discussing that wrong judgment and misdiagnose are easily caused by loss of typical image presentation of primary lesion due to larger lesion volume on its CT analysis. Method：14 cases of space occupying lesion of huge cyst verified by surgery and histopathology are collected, among which there are 8 cases of cystadenoma in abdominal cavity, including a case of being extra large type, 2 cases of cystadenocarcinoma,2 cases of endometrial cyst and 2 cases of mesenteric cyst. All cases are performed plain CT and a part of cases are performed plain CT and contrast enhanced CT or three-dimensional reconstruction.Results：These 14 cases are diagnosed as cystadenoma,the number of right diagnosed cases of cystadenoma in abdominal cavity is 8 cases, among which 4 cases are not performed contrast enhanced CT with difficult diagnosis and 2 cases are misdiagnose.Conclusions：Space occupying lesion of huge cyst in abdominal cavity has similar CT features. Under the case of larger lesion volume, lesion loses a part of typical image presentation so that brings certain difficulties to right diagnosis of disease, especially insufficient experience on diagnosis of localization and nature. It is helpful for mastering general principles of space occupying lesion of huge cyst in the development of disease that these difficulties are recognized.

关 键 词：巨大囊性占位性病变 腹部疾病 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R730.4[医药卫生—放射医学]