行腹膜透析后出现包裹性腹膜硬化的CT影像学特征及临床意义  

CT Imaging Features and Clinical Significance of Encapsulating Peritoneal Sclerosis after Peritoneal Dialysis

作　　者：王淼[1] WANG Miao(Department of Radiology,Beijing Hepingli Hospital,Beijing 10013,China)

机构地区：[1]北京市和平里医院放射科,北京100013

出　　处：《中国CT和MRI杂志》2021年第4期137-140,共4页Chinese Journal of CT and MRI

摘　　要：目的分析行腹膜透析后出现包裹性腹膜硬化的CT影像学特征以及临床意义。方法选取2015年1月至2018年6月期间于我院肾内科进行腹膜透析后出现包裹性腹膜硬化的32例患者作为研究对象,根据患者疾病的轻重进行分组,其中轻症包裹性腹膜硬化的18例患者作为轻症组,重症包裹性腹膜硬化的14例患者作为重症组,两组患者CT影像学特征进行分析,并对两组患者腹膜透析时间、腹膜厚度、腹膜钙化、腹部血管钙化以及相关并发症情况进行评估。结果轻症组包裹性腹膜硬化患者CT影像学特征为腹膜增厚以脏层与壁层腹膜增厚2.5~5.0mm为主,腹膜钙化以壁层腹膜游离缘零散分布小点状、沙粒状为主,小肠壁增厚以肠系膜缘增厚8~10mm为主,且未发现小肠钙化情况;重症组包裹性腹膜硬化患者CT影像学特征为腹膜增厚以壁层腹膜、脏层腹膜、大网膜以及肠系膜增厚超过5.0mm为主,腹膜钙化以壁层腹膜、脏层腹膜、大网膜、肠系膜以及小肠壁大范围广泛分布轨道状、短线状、簇状、团块状为主,小肠壁增厚以全层增厚10mm为主,小肠钙化广泛分布且以轨道状、短线状、簇状、团块状为主。轻症组包裹性腹膜硬化患者未存在肠道并发症以及其他并发症,但存在腹部脏器血管钙化,重症组包裹性腹膜硬化患者存在肠淤张、动力性肠梗阻肠道并发症,存在包裹性积液、腹壁病以及血肿等其他并发症,以及存在腹部脏器血管钙化。结论腹膜透析后出现包裹性腹膜硬化具有一定CT影像学特征,且轻症CT影像学特征与重症不同,可结合CT影像学特征与腹膜透析时间对患者进行诊断与分型。Objective To analyze the CT imaging features and clinical significance of encapsulating peritoneal sclerosis after peritoneal dialysis.Methods Thirty-two patients with encapsulating peritoneal sclerosis who underwent peritoneal dialysis in our nephrology department from January 2015 to June 2018 were divided into mild group(n=18,mild encapsulating peritoneal sclerosis)and severe group(n=14,severe encapsulating peritoneal sclerosis)according to the severity of the disease.The CT imaging features of the two groups were analyzed,and the peritoneal dialysis time,peritoneal thickness,peritoneal calcification,abdominal vascular calcification,and relevant complications were assessed.Results The CT imaging features in patients with mild encapsulating peritoneal sclerosis were characterized by the thickening of the peritoneum with thickening of the visceral and parietal peritoneum 2.5 to 5.0 mm,by the peritoneal calcification with parietal peritoneum free edge scattered with small dots and sands,andby the thickening of the small intestine with thickening of the mesenteric margin 8 to 10 mm,no small intestine calcification found.The peritoneal thickening cha racterized the CT imaging features in patients with severe enca psulating peritoneal sclerosis with thickening of the parietal peritoneum,visceral peritoneum,omentummajus and mesentery more than 5.0 mm,by the peritoneal calcification with parietal peritoneum,visceral peritoneum,omentum majus,mesentery and small intestine wall scattered with orbital,short-line,cluster-like and clump-like,and by the small intestine wall thickening with 10 mm thickening of the whole layer.Small intestine calcification was widely distributed and mainly orbital,short-line,cluster-like,and clump-like.Patients with encapsulating peritoneal sclerosis have no intestinal complications and other complications in the mild group,but had vascular calcification in the abdominal organs.In severe cases,patients with enca psulating peritoneal sclerosis had intestinal stenosis,dynamic intestinal obstruct

关 键 词：腹膜透析 包裹性腹膜硬化 CT影像学特征 临床意义 

分 类 号：R656.4[医药卫生—外科学] R445.3[医药卫生—临床医学]