儿童梅克尔憩室的CT诊断价值  

CT diagnostic value of Meckel′s diverticulum in children

作　　者：陈园园[1] 张嫣[1] 王霞[1] 张若仙 江肖松 李鸿恩 CHEN Yuan-yuan;ZHANG Yan;WANG Xia(Department of Radiology,Guangdong Women and Children Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院放射科,广东广州510010

出　　处：《放射学实践》2024年第4期528-533,共6页Radiologic Practice

摘　　要：目的:探讨CT检查对儿童梅克尔憩室(MD)的诊断价值。方法:回顾性分析2013年1月-2022年12月在本院经手术病理证实的36例MD患儿的临床及CT资料。结果:36例MD在CT上均能显示。病变部位:位于右下腹18例,右中腹7例,中下腹部中线处7例,左侧中下腹部5例。憩室的形态:MD呈囊袋状扩张者11例(11/36),一端呈窄颈状与回肠相连,另一端盲端明显扩张,MD的长度为1.5~4.1 cm、宽度为0.8~1.7 cm,增强后囊壁明显强化,尤其在动脉期与正常小肠黏膜对比最显著明显;MD呈指状结构者25例(25/36),一端与回肠相连,另一端为盲端且无明显扩张,MD的长度为2.2~5.2 cm、宽度为0.5~1.0 cm,MD管腔自起始端至盲端逐渐变细,管腔内壁毛糙,腔内有少量液体,部分内壁贴合,增强后动脉期憩室-回肠连接部及憩室壁对比最显著。23例合并肠系膜淋巴结肿大,24例合并腹水。结论:CT不仅可以显示MD的形态及其与周围肠管和肠系膜的空间关系,还能准确判断病变范围,术前行CT检查,对于外科手术方式的选择具有指导意义。Objective:The aim of this study was to explore the clinical value of CT in the diagnosis of Meckel′s diverticulum(MD)in children.Methods:From Jan.2013 to Dec.2022,the clinical data and CT images of 36 children with Meckel′s diverticulum confirmed by post-surgical pathology in our hospital were retrospectively analyzed.Results:The MD lesions in all 36 cases were shown on CT images.Lesion location:right lower abdomen(n=18),right middle abdomen(n=7),mid-line of the middle lower abdomen(n=7),left middle and lower abdomen(n=5).Lesion shape:there were two types of MD,saccular or fingerlike.Saccular dilatation of MD was found in 11 cases(11/36),with narrow-neck connected to the ileum and obvious dilatation at the blind end,the length was 1.5~4.0cm and the width was 0.8~1.7cm;after enhancement,the cyst wall was markedly enhanced,and the contrast enhancement between MD and intestinal mucosa was most obvious in artery phase.Finger-like structure was shown in 25 cases(25/36),with blind end at one side and the other end connected with ileum,the length was 2.2~5.2cm and the width was 0.5~1.0cm.The lumen of MD gradually tapered from the primary end to the blind end;and the inner wall of the lumen was rough with a small amount of liquid and partial adhesion.After enhanced scan,the contrast between diverticulum and ileum junction and diverticulum wall was apparently enhanced.23 cases were complicated with mesenteric lymph node enlargement,and 24 cases were complicated with ascites.Conclusion:CT scan can not only show the form of MD as well as its spatial relationship with the surrounding intestine and mesentery,but also can clearly show the scope of lesion.Preoperative CT scan can provide helpful instruction for the surgical method.

关 键 词：梅克尔憩室 小肠疾病 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R574.5[医药卫生—放射医学]