腹腔纱布肉芽肿的MSCT征象分析  

The multi-slice CT features of intraabdominal gossypiboma

作　　者：赵旭[1] 张进华[1] 高小玲[1] 沈亚琪[1] 周志强[1] 胡道予[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2016年第5期411-415,共5页Radiologic Practice

基　　金：国家自然科学基金面上项目(81571642;81371524)

摘　　要：目的：总结分析腹腔纱布肉芽肿的典型及不典型MSCT征象。方法：回顾性分析经手术病理证实的5例腹腔纱布肉芽肿的临床及影像学资料,所有患者均行腹部MSCT平扫及增强扫描。结果：5例患者纱布遗留在腹腔的时间为2.5个月~8年。5例中有3例纱布肉芽肿移位至腹腔脏器内,其中远段回肠1例,十二指肠球部及胃窦部1例,乙状结肠内1例;余2例纱布肉芽肿位于腹膜腔,其中1例位于左下腹,1例位于右上腹。5例均表现为类圆形或卵圆形肿块影,周围均可见厚薄不均的软组织构成的壁,其中2例可见金属标记,3例内部呈＂蜂窝征＂,1例呈＂类漩涡征＂,1例呈＂漂浮征＂,2例呈＂血管卷入征＂。结论：MSCT增强扫描可为腹腔纱布肉芽肿的诊断提供重要依据,＂蜂窝征＂是其典型CT表现,另外还可见＂类漩涡征＂、＂漂浮征＂、＂血管卷入征＂、＂钙化网状外壳征＂等不典型征象。Objective：The purpose of this study was to investigate the typical and atypical multi-Slice CT（MSCT）features of intraabdominal gossypiboma.Methods：The clinical and MSCT data of 5cases with pathologically confirmed gossypiboma were retrospectively analyzed.All patients underwent an abdominal enhanced CT scan.Results：All foreign bodies were left behind during the abdominal operation.The intervals between the causative operation and diagnosis of gossypiboma ranged from 2.5months to 8years.Three of 5gossypibomas migrated into the abdominal organs with 1in the ileum,1in the duodenal bulb and the gastric antrum,and 1in the sigmoid colon,respectively.Two of 5were located in the abdominal cavity with 1in the left lower quadrant,and 1in the right upper quadreant.All gossypibomas appeared as either rounded or oval masses with a peripheral uneven-thickness rim.Two of them contained radiopaque metal markers.Three showed with a spongiform gas bubble sign,1with a whirl-like sign,and 1with a wavy striped sign.Two cases had blood vessel growth.Conclusion：MSCT is the most commonly used and most effective method for detection of gossypiboma.Spongiform gas bubble sign is the most typical CT characteristic of gossypiboma,and the other atypical characteristics included whirl-like sign,wavy striped sign,vessel growth and calcified reticulated rind sign.

关 键 词：纱布肉芽肿 外科纱布 体层摄影术 X线计算机 诊断 鉴别 

分 类 号：R57[医药卫生—消化系统] R816.5[医药卫生—内科学]