多层螺旋CT对肠系膜原发非肿瘤性病变的诊断价值  

MSCT findings of mesenteric primary non- neoplastic lesions

作　　者：贾成[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：《吉林医学》2013年第34期7111-7113,共3页Jilin Medical Journal

摘　　要：目的:探讨多层螺旋CT(MSCT)对肠系膜原发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44例肠系膜原发非肿瘤性病变的CT表现与诊断,其中34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1.25 mm层厚和1 mm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:44例中肠系膜水肿17例,包括门脉、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,大网膜梗死1例,肠脂垂炎2例;炎性渗出7例,包括肠系膜脓肿4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。肠系膜原发性非肿瘤性病变的主要MSCT表现:肠系膜密度增高42例,其中弥漫性发布23例,节段性分布19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12例,4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:常见的肠系膜原发性非肿瘤性病变种类多、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 value of the multislice helical CT （MSCT） in diagnosing primary non - neoplastic lesions of mes- enter,/. Method The imaging features of 44 eases with primary non - neoplastic lesions of mesentery （34 cases had histopathologio results by biopsy or/and operating） were reviewed. Biphaseenhaneed abdominal CT examination was performed with GE Light Speed Pro16 can- ner. Maximum intensity projection（MIP） and multlplanar reformation（MPR） were generated by using 1.25 mm thickness and 1 mm recon- struction on ADW4.2 Workstation to assess the changes of mesentery,to evaluate the chamge of mesenteric vessels and adjacent organs in different lesions. Results In 44cases：IT patients bad mesenteric edema ,including 4 cases of portal vein ,superior mesenterie vein thrombo- sis, superior mesenteric artery embolism and mesenteHc reverse each;2 cases of superior mesenteric veln,portal vein wide range of product gas and primary epiploic appendagitis each. 1 case of omentum embolism. 7 cases of patients had inflammatory exudate, including 4 cases of mesenterie abscess , 3 cases of lymphadenitis. 10 cases of patients had mesenterie vascular contusion,of them 4 eases with intestinal rup- ture. 10 cases patients had other diseases,2 cases of fat deposition,8 eases of mesenteHe pannieulitis. Mesenteric primary non - neoplastic lesions of the main MSCT findings：The mesentery density increased in 42 cases, Diffuse misty mesentery in 23 cases, segmental misty mes- entery in 19 cases, The lesions showed cloudy mist striation increased mesenteric. Fluid within the intestinal clearance in 12 cases, pneuma- tosis in 4 cases. Fatty mass from mesenteric root in 8 cases, Mesenterie thickening was cable - like changes in 2 cases, Mesenteric rotation in 4 cases ,The contrast agent within the mesenterie vascular defect in 8 cases, pneumatosis in 2 cases, superior mesenterle artery thicken- ing in 4 cases, lymphadenitis in 3 cases showed multiple small nodules, Blurred edges. Conclusion Common mesentery non -

关 键 词：肠系膜 原发 非肿瘤 多层螺旋 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]