脐尿管常见病变的影像学表现  

Imaging features of the common lesions in urachus

作　　者：王龙 张娇娇 王渊[1] WANG Long;ZHANG Jiaojiao;WANG Yuan(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Pathology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Imaging Center,Qingyang People's Hospital,Qingyang,Gansu Province 745000,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]西安交通大学第一附属医院病理科,陕西西安710061 [3]庆阳市人民医院影像中心,甘肃庆阳745000

出　　处：《实用放射学杂志》2022年第8期1310-1313,共4页Journal of Practical Radiology

摘　　要：目的探讨脐尿管病变的影像学特征,以提高诊断正确率.方法收集经病理证实的17例脐尿管病变的影像学检查资料,对其影像学特征进行回顾性分析.结果17例患者病变均位于腹中线脐尿管走行区.慢性炎性病变6例,呈条片状软组织密度,形态尚规整,周围脂肪间隙毛糙、模糊;脐尿管癌4例,呈团块状不均匀软组织密度/信号,形态不规则,其内可伴坏死及钙化,增强扫描呈囊实性不均匀强化,实性部分扩散加权成像(DWI)呈高信号,表观扩散系数(ADC)图呈低信号.脐尿管囊肿1例,呈类圆形稍高密度影,边界清楚,增强扫描强化不明显;脐尿管囊肿伴炎症3例,呈囊实性改变,增强扫描可见环状强化影,周围炎性部分轻度强化.脐尿管瘘1例,呈脐至膀胱顶部管状结构,管壁较厚.脐尿管窦道1例,呈类圆形软组织密度影,其内可见裂隙样低密度.脐尿管平滑肌并血管瘤浸润1例,密度均匀,增强扫描静脉期可见线样强化影.结论脐尿管慢性炎症和脐尿管癌的CT和MRI征象具有一定特点,即脐尿管慢性炎症形态较规整、周围脂肪间隙毛糙,合并脓肿密度可不均匀,钙化多为单发,增强扫描轻中度强化;脐尿管癌多呈软组织肿块、形态不规则、钙化多为多发,增强扫描明显强化.Objective To improve the diagnostic accuracy for urachus lesions by exploring the imaging features of the diseases.Methods 17 pathologically confirmed urachus lesions were collected,then the imaging characteristics were retrospectively analyzed.Results In these 17 patients,all of the lesions located in the umbilical ureteral region in the abdominal midline.There were 6 cases of chronic inflammatory lesions with striated soft tissue density,regular morphology and gross,blurred surrounding fatty interstices;4 cases of umbilical ureteral carcinoma showed mass-like inhomogeneous soft tissue density/signal with irregular morphology,which could be accompanied by necrosis and calcification,with cystic-solid inhomogeneous enhancement on enhancement scan,high signal on diffusion weighted imaging(DWI)and low signal on apparent diffusion coefficient(ADC)mapping in solid part.1 case of umbilical ureteral cyst with a round-like,slightly high-density shadow with clear borders and unremarkable enhancement on enhancement scan;3 cases of umbilical ureteral cysts with inflammation showed solid-cystic changes,and enhancement scans revealed a ring-like enhancement shadow with mild enhancement of the surrounding inflammatory parts.1 case of umbilical ureteral fistula showed a tubular structure from the umbilicus to the top of the bladder with a thick wall.1 case of umbilical ureteral sinus tract showed a round-like soft tissue density shadow with fissure-like hypo-density shadow visible within the lesion.1 case of infiltration of the umbilical ureteral leiomyoangioma,showed homogeneous density and a linear contrast in the venous phase of the enhancement scan.Conclusion The CT and MRI signs of chronic inflammation and carcinoma of the umbilical ureteral have certain characteristics:chronic inflammation of the umbilical ureteral has a regular morphology,the surrounding fatty space is gross,the density is not uniform if combined with abscess,the calcification is mostly solitary and the enhancement scan shows mild to moderate enhancement

关 键 词：脐尿管病变 计算机体层成像 磁共振成像 

分 类 号：R657.7[医药卫生—外科学] R814.42[医药卫生—临床医学] R445.2