多层螺旋CT多平面重组诊断食管裂孔网膜疝  

The Diagnostic Value of Multiplanar Reformation By Multislice Spiral CT in Esophageal Hiatus Omental Herina

作　　者：曹和涛[1] 陆健[2] 周亚生[2] 刘婷婷[1] 田浩[1] 生晓惠[1] 陈小华[1] 张勤慧[1] 包雪平[1] 刘晓艳[1] 

机构地区：[1]南通大学附属医院影像科,226001 [2]南通大学附属第三南通医院影像科

出　　处：《临床放射学杂志》2012年第11期1659-1662,共4页Journal of Clinical Radiology

摘　　要：目的探讨MSCT多平面重组(MPR)诊断食管裂孔网膜疝(EHOH)的价值。方法 5例经手术证实的EHOH均行MSCT平扫及增强检查,获取亚毫米数据作MPR及最大密度投影(MIP),在贲门部测量食管裂孔(EH)大小。以EH膈上脂肪囊与腹腔网膜脂肪相连、胃左动脉(GLA)穿EH及贲门位置正常作为EHOH诊断标准,由3位不知手术结果的高年资医生分别回顾性分析横断位和MPR图像进行判断。结果 5例横断位均显示EH膈上大小不等囊状脂肪密度影,其中椭圆形2例、类圆形2例及分叶形1例,内见点条状高密度影,增强有强化;1例伴转移性淋巴结肿大,1例伴小网膜转移,3例伴腹腔积液;2例判断准确。5例MPR直观显示脂肪囊与腹腔脂肪相连,4例GLA穿EH,主干僵直和食管支附近呈"∩"形特征形态;5例均作出准确诊断。结论 MSCT MPR清晰显示EH膈上脂肪囊与腹腔网膜脂肪相连及GLA穿EH的形态特征,对EHOH诊断具有重要意义。Objective To explore the value of multiplanar reformation（MPR） by multislice spiral CT in the diagnosis of esophageal hiatus omental herina（EHOH）.Methods 5 cases of EHOH confirmed by surgery were examined by MSCT plain and enhanced scanning,the submillimeter data was made for MPR and MIP.The size of esophageal hiatus（EH） was measured in the plane of gastroesophageal connection.The diagnostic criteria for EHOH included the fat sac above diaphragmatic EH continuous with the omental fat within the abdominal cavity,the gastric left artery（GLA） through EH and normal position of gastroesophageal connection.Three experienced radiologists blindly analyzed retrospectively the image data of 5 patients to make judgment respectively.Results 5 cases were all displayed the sizes of cystic fat density shadows above diaphragmatic esophageal hiatus（EH）on a cross sectional image,of which 2 cases were oval,2 cases with class circle and 1 case with lobulated on a cross sectional image and in which some point and strip hyperdensity shadows with enhancement were displayed.There were 1 case with metastatic lymph node enlargement,1 case with the superior recess of lesser sac metastases,3 cases with ascites.The fat sac was directly showed continuous with the omental fat within the abdominal cavity in coronal and sagittal MPR,The point and strip hyperdensity on a cross sectional were proved to be the abdominal vessels section which through EH.CTA can clearly display GLA through EH and the morphological characteristics of the stiff major trunk of GLA and ＂∩＂ form of GLA near the esophagus branch.5 cases had been all made to the accurate diagnosis.Conclusion MSCT can clearly display the fat sac above diaphragmatic EH continuous with the omental fat within the abdominal cavity and the morphological characteristics of GLA through EH,which has an important role in the diagnosis of EHOH.

关 键 词：疝 食管裂孔 体层摄影术 X线计算机 多平面重组 

分 类 号：R816.4[医药卫生—放射医学]