MSCT对肠系膜非肿瘤性病变的诊断  

MSCT Findings of Mesenteric Non- neoplastic Lesions

作　　者：贾成[1] 孙敏[1] 罗彩华[1] 高爱东[1] 

机构地区：[1]江苏省靖江市人民医院放射科,江苏靖江214500

出　　处：《中国CT和MRI杂志》2013年第5期77-80,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨多层螺旋CT(MSCT)对肠系膜非肿瘤性病变的诊断价值。方法回顾性分析经手术病理及随访观察证实的84例肠系膜非肿瘤性病变的CT表现与诊断,其中72例经穿刺/手术病理证实,其余按照CT标准做出诊断。应用GE LightSpeed Pro 16 CT机进行腹部平扫和双期增强扫描,并采用1.25mm层厚和1mm重建间隔在ADW4.2工作站获取最大密度投影(MIP)和多平面重建(MPR)图像,评价不同病变时肠系膜及其血管及邻近脏器的改变。结果 84例中:肠系膜水肿30例,其中肝硬化所致10例,肾衰所致4例,门脉、肠系膜上静脉栓塞4例,肠系膜上动脉栓塞4例,肠系膜扭转4例,肠系膜上静脉、门脉广泛积气2例,肠脂垂炎2例;炎性渗出34例,其中胆囊炎、阑尾炎、附件炎各6例,胰腺炎、升结肠憩室炎2例,肠系膜脓肿4例,肠穿孔5例,淋巴结炎3例;肠系膜血管挫伤10例,其中4例合并肠破裂;其他病变10例,包括脂肪沉积2例,肠系膜脂膜炎8例。肠系膜非肿瘤性病变的主要MSCT表现:肠系膜密度增高82例,其中弥漫性发布39例,节段性分布43例,表现为肠系膜雾状线条状增高即云雾状肠系膜。肠间隙内积液37例,9例同时伴积气。环绕肠系膜根部的脂肪肿块样改变8例,肠系膜增厚呈缆绳样改变2例,肠系膜旋转4例,肠系膜血管内对比剂缺损8例、积气2例,肠系膜上动脉增粗4例。3例淋巴结炎表现为回盲部多发小结节,边缘模糊。结论常见的肠系膜非肿瘤性病变病种多、表现相近,大部分具有特征性的CT表现,必须结合病史,方可提高定性诊断符合率。Objective To evaluate the multislice helical CT （MSCT） manifestations of non - neoplastic lesions of mesentery. Methods The imaging features of 84 cases with non - neoplastic lesions of mesentery （72 cases had histopathologic results by biopsy or/and operating） were reviewed. Biphaseenhanced abdominal CT examina- tion was performed with GE LightSpeed Pro l6 canner. Maximum intensity projection（MIP） and multiplanar retbrmation（MPR） were generated by using 1. 25mm thickness and 1 mm reconstruction on ADW4.2 Workstation to assess the changes of mesentery,mesenteric vessels and adjacent organs in different lesions, Results In 84 cases： 30 patients had mesenteric edema, including 10 cases of liver Cirrhosis： 4 cases of renal failure, portal vein, superior mesenteric vein thrombosis, superior mesenteric artery embolism and mesenteric reverse each： 2 cases of supe- rior mesenteric vein, portal vein wide range of product gas and primary epiploic appendagitis each, 34 cases patients had inflammatory exudate, including 6 cases of cholecystitis, appendicitis and adnexitis eac; 2 cases of pancreatitis, ascending colon diverticulitis; 4 cases of mesenteric abscess; 5 cases of intestinal perforation and 3 cases of lymphadenitis. 10 cases patients had mesenteric vascular contusion, of them 4 cases with intestinal rupture. 10 cases patients had other diseases, 2 cases of fat deposition, 8 cases of mesenteric panniculitis. Mesenteric non- neo- plastic lesions of the main MSCT findings： The mesentery density increased in 82 cases, Diffuse misty mesentery in 39 cases,segmental misty mesentery in 43 cases, The lesions showed cloudy mist striation increased mesenteric.Fluid within the intestinal clearance in 37 cases, pneumatosis in 9 cases. Fatty mass from mesen- teric root in 8 cases, Mesenteric thickening was cable -like changes in 2 cases, Mesenteric rotation in 4 cases, The contrast agent within the mesenteric vascular defect in 8 cases, pneumatosis in 2 cases, superior mesenteric artery thickening in 4 c

关 键 词：肠系膜 非肿瘤 多层螺旋 体层摄影术 X线计算机 

分 类 号：R73[医药卫生—肿瘤] R814.42[医药卫生—临床医学]