肠系膜脂膜炎的CT定量影像与分型  

Quantitative imaging and classification of mesenteric panniculitis

作　　者：李文华 熊瑶 耿云平[1] 张毅 李天然 LI Wenhua;XIONG Yao;GENG Yunping;ZHANG Yi;LI Tianran(Department of CT Imaging Diagnosis,Nanyang Central Hospital,Nanyang 473000;Department of Diagnostic Radiology,the Fourth Medical Center of General Hospital of PLA,China)

机构地区：[1]南阳市中心医院CT影像科,河南南阳473000 [2]中国人民解放军总医院第四医学中心放射诊断科

出　　处：《胃肠病学和肝病学杂志》2024年第8期995-998,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的 分析肠系膜脂膜炎(mesenteric panniculitis, MP)的定量影像学特点并进行分型,提高对MP的影像认识。方法 对64例MP患者的临床和CT检查数据进行回顾性分析,并根据CT表现和临床综合诊断将患者分为炎性渗出型、脂肪坏死型和纤维化型。通过对肠系膜病变组织和同层面正常腹膜后脂肪组织进行ROI勾画和CT值测量。结果 64例MP患者中50例炎性渗出型,8例脂肪坏死型,6例纤维化型。病变部位均发生在肠系膜根部,并且向左侧延伸至小肠肠袢,肠系膜脂肪密度增高并出现增生结节。64例患者中50例出现“脂肪环征”,56例出现“假包膜征”,37例同时出现“假包膜征+脂肪环征”,9例同时出现“假包膜征+脂肪环征+血管僵硬、粗细不均”。病变肠系膜脂肪密度高于正常腹膜后脂肪组织,MP区域CT值为(-55.01±17.88)HU,正常腹膜后脂肪组织为(-99.44±8.67)HU,两者比较差异有统计学意义(P<0.001)。不同分型的肠系膜病变CT值之间有显著性差异(P<0.001)。结论 MP的CT表现具有一定的特征性,同时肠系膜病变的CT值可作为MP分型的依据,有助于临床制定合理治疗方案。Objective To analyze the imaging characteristics and types of mesenteric panniculitis(MP)and improve the clinical diagnosis of MP.Methods The clinical and CT examination data of 64 patients with MP were analyzed retrospectively,and the patients were divided into inflammatory exudative type,fatty necrosis type and mild fibrosing type based on CT features and clinical diagnosis.CT values were measured by ROI outling of mesenteric lesion tissue and normal retroperitoneal adipose tissue at the same level.Results Among the 64 cases of MP,50 cases were inflammatory exudative type,8 cases were fatty necrosis type,and 6 cases were mildfibrosing type.The lesions all occurred at the mesenteric root and extended to the left side to the small intestine collaterals,and all showed increased mesenteric fat density and hyperplastic nodules.Fifty cases showed as fat ring sign,56 cases showed as false capsule sign,37 cases showed as false capsule sign+fat ring sign,and 9 cases were seen as false capsule sign+fat ring sign+blood vessel stiffness and uneven.The lesion mesenteric fat density was higher than that of normal retroperitoneal adipose tissue,with a CT value of(-55.01±17.88)HU in plain scan and(-99.44±8.67)HU in normal retroperitoneal adipose tissue,and the difference was statistically significant(P<0.001).There was a significant difference in CT values of mesenteric lesions of different types(P<0.001).Conclusion The CT manifestation of MP has certain characteristics,and the CT value of mesenteric lesions can be used as a basis for MP classification,which is helpful to make reasonable clinic treatment plan.

关 键 词：肠系膜脂膜炎 计算机断层扫描 假包膜征 脂肪环征 分型 

分 类 号：R57[医药卫生—消化系统] R814.42[医药卫生—内科学]