硬化性肠系膜炎CT诊断价值  

The diagnostic value of CT in sclerosing mesenteritis

作　　者：胡卫东[1] 梁冰[1] 王秀荣[1] 朱记超[1] 谢尚煌[1] 鄂占森[2] 

机构地区：[1]广东省深圳市龙岗中心医院医学影像科,广东深圳518116 [2]广东省深圳市龙岗中心医院超声科,广东深圳518116

出　　处：《医学影像学杂志》2017年第5期855-857,共3页Journal of Medical Imaging

摘　　要：目的探讨硬化性肠系膜炎CT诊断价值。方法回顾性分析8例经临床确诊硬化性肠系膜炎患者临床资料及CT图像,评价CT诊断价值。结果 1)临床资料:回顾性分析2000例住院患者腹部CT,发现8例硬化性肠系膜炎(8/2000=0.4%),发病率为0.4%;男5例(62.5%),女3例(37.5%);年龄:46~68岁,平均年龄(57.8±6.2)岁。5例患者可触及腹部包块(5/8=62.5%);2)影像资料:CT主要表现为卵圆形脂肪密度病灶,位于结肠的侧方或前方,周围系膜可见炎性渗出环形包绕,呈明显的高密度边缘征象,少数中央可见点状、条状高密度,为栓塞的血管或出血。增强扫描未见明确强化,内可见包绕走行血管影。邻近的肠壁此时可见增厚或受压,周围出现不成比例的脂肪绞缠征。CT平扫时正常腹膜后脂肪组织的CT值为-85^-121(-106±-12.5)HU,硬化性肠系膜炎病变处CT值为-54^-38(-48±-7.6)HU,正常部位脂肪组织明显低于病变部位密度(2=18.67,P<0.05)。结论硬化性肠系膜炎具有典型的临床表现及特征性的CT征象,CT为其首选的检查手段,可对该病做出明确诊断。Objective To investigate the diagnostic value of CT in sclerosing mesenteritis. Methods We retrospectively ana- lyzed abdomen images of 8 cases and observed the clinical data and imaging characteristics of selerosing mesenteritis. Results 1 ） clinical data： CT findings of sclerosing mesenteritis were seen in 8 case from 2000 patients. The prevalence of mesenteric pan- niculitis was 8/2000 - 0.4%, whose age ranged from 46 to 68 years （57.8 ± 6.2） years, with mean age of 64 years. We found that 8 cases of sclerosing mesenteritis that had been included 5 men （5/8 = 62.5% ） and 3 women （3/8 = 37.5% ） and 5 abdom- inal mass （5/8 =62.5% ）; 2） image data： CT scan showed mesenteric vessels surrounded by mesenteric panniculitis as scat- tered, discrete nodules of soft-tissue density, engulfed by hypodense fatty halo. Contrast-enhanced CT scan showed mesenteric vessels enveloped by mesenteric panniculitis and had the disproportionate fat stranding sign. Normal CT value of retroperitoneal adipose tissue was - 85 - - 121 （ - 106 ± - 12.5） HU and mesenteric panniculitis was - 54 - - 38 （ - 48 ± - 7.6） HU. There was statistically significant difference in mesenteric panniculitis and the normal （χ^2 = 18.67, P 〈 0.05 ）. Conclusion CT is the preferred means of checking and can make a definite diagnosis of the disease because of sclerosing mesenteric with typical clinical presentation and characteristic CT signs.

关 键 词：硬化性肠系膜炎 脂膜炎 腹膜 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]