单纯腹腔网膜脂肪突入食管裂孔多层螺旋CT多平面重组的表现及意义  

Performance and Significance of Multiplanar Reformation in Multi-slice Spiral CT Examination of Herniation of Pure Abdominal Omental Fat into Esophageal Hiatus

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] 葛涌钱[1] 刘晓艳[1] 

机构地区：[1]南通大学附属医院影像科 [2]南通大学附属南通第三医院影像科

出　　处：《中国医学计算机成像杂志》2013年第4期337-341,共5页Chinese Computed Medical Imaging

摘　　要：目的：研究单纯腹腔网膜脂肪（PAOF）突入食管裂孔（EH）形态特征，探讨MSCT诊断EH单纯网膜脂肪疝的价值和限度。方法：回顾性分析2008年12月-2012年8月MSCT横断位发现EH膈上脂肪囊41例，获取亚毫米资料作MPR及MIP，观察脂肪囊、胃左动脉（LGA）形态特征及其与EH关系。结果：41例脂肪囊横断位呈类圆形15例，椭圆形17例和分叶形9例，23例囊内显示点条状血管影。MPRI-11例脂肪囊呈狭基底形（疝囊形），30例呈广基底形（膨隆形），其底部均与腹腔网膜脂肪相连。囊内血管主要为LGA及其分支，其中9例LGA主干僵直，食管支附近呈对称性“∩”形突入胸腔，脂肪囊均为疝囊形；32例走向自然未进胸腔，30例脂肪囊呈膨隆形（X^2=19．988，P=0．031）。结论：PAOF突入EH横断位表现为膈上类圆／椭圆份叶形脂肪囊；MPR上大致呈膨隆形和疝囊形两种形态，前者提示EH功能减退，后者结合LGA“∩”形突入胸腔征象有助于网膜脂肪疝诊断。Purpose： To study the morphological characteristics of herniation of pure abdominal omental fat （PAOF） into the esophagus hiatus （EH）, in order to investigate the value and limitation of MSCT to diagnosis EH omental fat hernia. Methods： Forty-one cases of fat sac above the diaphragmatic esophageal hiatus （EH） were studied on cross-sectional images prospectively from December 2008 to August 2012. The sub-millimeter data were reconstructed with MPR and MIP. The morphological characteristics of fat sac, left gastric artery （LGA） and its relation to EH were observed. Results： Of 41 cases, 15 cases of fat sac presented similar round, 17 presented oval and 9 case showed lobulated in shape on cross-sectional images, 23 cases showed some strip of blood vessels in the sac. On MPR, ll fat sac showed a narrow base （hernia form）, 30 cases presented a wide base （bulge form）, all the bottoms connected with abdominal omental fat. LGA and its branches were the main blood vessels in the sac, of which, 9 cases of the LGA trunk was stiff, and it pass through EH near the esophagus branch with a symmetric ＂∩＂. The sac was all hernia form in shape; 32 cases LGA run naturally and not into the chest cavity, 30 cases were bulge （Z2=19.988, p=0.031）. Conclusion： The manifestation of herniation of PAOF into EH were presented similar round or oval or lobulated in shane on cross-sectional images;Bulge and hernia shape on MPR, the former hinted the hypofunction of EH, the later combined with the manifestation of LAG into thoracic cavity with the shape of ＂∩＂ was helpful for diagnosis EH omental fat hernia.

关 键 词：疝 食管裂孔 网膜 多层螺旋CT 

分 类 号：R816.1[医药卫生—放射医学]