单纯腹腔网膜脂肪突入膈肌裂孔临床相关性及MSCT表现特征研究  

Study on clinical correlation and image features of herniation of pure abdominal omental fat into diaphragm hiatus

作　　者：苏海[1] 曹和涛[1] 于芹[1] 田浩[1] 刘婷婷[1] 陈小华[1] 

机构地区：[1]南通大学附属医院影像科,江苏南通226001

出　　处：《医学影像学杂志》2015年第1期82-87,共6页Journal of Medical Imaging

摘　　要：目的探讨单纯腹腔网膜脂肪突入膈肌裂孔("孔征")临床相关性及CT表现特征。方法搜集MSCT检查发现"孔征"患者116例,分析:1"孔征"脂肪囊、网膜血管形态特征及相关性;2"孔征"检出率与其部位、肝硬化、年龄和性别相关性并行2检验;3不同部位及类型"孔征"脂肪囊大小差异并行t检验。另随机选取无"孔征"患者41例,测量腹腔矢状径,与等量全腹扫描"孔征"组比较并行t检验。结果116例"孔征"脂肪囊主要呈类圆、半月、分叶和梨形,MPR主要呈膨隆和疝囊形2类,网膜血管多僵直指向裂孔,其中,23例呈扇骨状或"∩"形突入裂孔,26例囊内积液,4例呈脂中脂征象。"孔征"总检出率为0.91%,其中,胸腹膜、食管和IVC裂孔分别为0.17%、0.45%和0.30%;后两者显著多于前者(P<0.05);老、中、青三组分别为1.74%、0.69%和0.38%,老年组显著高于中青年组(P<0.01);男女组分别为1.09%和0.69%(P<0.05);腔静脉裂孔肝硬化组为3.33%,无肝硬化组为0.30%(P<0.01)。疝囊形各径值显著大于膨隆形(P<0.05);腹腔矢状径均值"孔征"组为(12.36±5.01)cm,对照组为(10.12±4.22)cm(P<0.05)。结论"孔征"与年龄、性别、肥胖和肝硬化相关,膨隆形脂肪囊网膜血管僵直指向裂孔及疝囊形脂肪囊网膜血管僵直"∩"形突入裂孔是其形态特征;前者提示裂孔功能减退,后者提示单纯性裂孔网膜疝形成。Objective To discuss the clinical correlation and image features of herniation of pure abdominal omental fat into diaphragm hiatus （＂hiatus symptom＂）. Methods 116 patients with the ＂hiatus symptom＂ found hy MSCT were collected and analysed. （1）The morphological characteristics of adipose capsules and omental vessels of ＂hiatus symptom＂ as well as their correlation; （2）The relationship of the detection rate of ＂hiatus symptom＂ between its position, cirrhosis, patients age and gender, with the statistical data analyzed by X2 test method; QThe difference between the sizes of ＂hiatus symptom＂ adipose capsules in various positions and of various types and tested by t. In addition, 41 patients without the ＂ hiatus symptom＂ were randomly selected, their abdominal sagittal diameters were measured and compared them with those of patients with the ＂hiatus symptom＂ and tested by t. Results The ＂hiatus symptom＂ adipose capsules of 116 patients were shaped mainly like quasi-circle, half-moon, phyllode and pyriform. MPR was mainly in the two shapes of bulge and hernia sac. 23 eases of omental vessel trunks were rigid, fan rib or ＂∩＂ shaped and herniate into thoracic cavity. 26 pa- tients had hydrops in the capsules. 4 patients had the phenomenon of fat-in-fat. The total detection rate of ＂hiatus symptom＂was 0. 91%, among which the detection rate of pleura and peritoneum hiatus was 0. 17%, that of esophageal hiatus was 0. 45%, and that of IVC hiatus was 0.30~. The latter two were significantly higher than the former （ P〈0.05） ; The detection rates of the elderly, middle-aged and youth groups were 1.74%, 0.69% and 0.38% respectively. The former was significantly higher than the latter two （ P 〈0.01） ; The detection rates of male and female groups were 1.09% and 0.69% （ P 〈0.05） respectively; The detection rates of ＂hiatus symptom＂ of vena eava hiatus of patients with or without cirrhosis were 3.33% and 0.30% （ P 〈0.01） respectively; The every diame

关 键 词：脂肪 网膜 膈肌裂孔 体层摄影术 X线计算机 

分 类 号：R657.2[医药卫生—外科学] R814.42[医药卫生—临床医学]