急性原发性肠脂垂炎多排螺旋CT检查特征及临床价值

Features and clinical value of multi slice spiral computed tomography examination of acute primary epiploic appendagitis

  • 摘要: 目的:总结急性原发性肠脂垂炎的多排螺旋CT检查特征,探讨其临床价值。
    方法:回顾性分析2009年12月至2014年3月扬州市第一人民医院收治的19例急性原发性肠脂垂炎患者的临床资料。患者行多排螺旋CT检查,将所有数据传输至CT后处理工作站进行多平面重建。观察病灶的部位、形态、大小、密度及周围表现、腹膜是否增厚等影像学表现。
    结果:19例患者的病灶均位于结肠旁。病灶部位:盲肠旁1例,升结肠旁4例,结肠肝曲旁1例,降结肠旁6例,乙状结肠旁7例。病灶形状:呈卵圆形或戒指样14例,呈火焰样5例。病灶直径为0.8~3.7 cm。CT平扫:病灶为低密度团块呈脂性密度,CT值为-101~-34 HU,中心密度较低,边缘密度较高。CT增强扫描:病灶常呈环状强化,周围脂肪间隙模糊,见片絮状稍高密度炎症区域,9例患者病灶中央见点状或线条状稍高密度影;局部腹膜增厚14例;局部结肠壁水肿增厚1例;盆腔积液5例。4例患者复查CT结果示:周围炎症区域缩小、消失,病灶缩小、结节化、钙化。结论:多排螺旋CT检查结果具有特征性,联合多平面重建能准确诊断急性原发性肠脂垂炎。

     

    Abstract: Objective:To summarize the features of multislice spiral computed tomography (MSCT) examination of acute primary epiploic appendagitis, and investigate the clinical value of MSCT.
    Methods:The clinical data of 19 patients with acute primary epiploic appendagitis who were admitted to the Yangzhou No.1 Hospital from December 2009 to March 2014 were retrospectively analyzed. All the patients received MSCT examination, and the data were transported to the work station for multiplanar reconstruction. The location, shape, size, density, peripheral performance and peritoneal thickening were observed.
    Results:The foci of the 19 patients were located adjacent to the colon. One focus was adjacent to the cecum, 4 were adjacent to the ascending colon, 1 was adjacent to the hepatic flexure of the colon, 6 were adjacent to the descending colon, and 7 were adjacent to the sigmoid colon. The shapes of the foci were similar to the oval or ring in 14 cases and similar to the flame in 5 cases. The diameters of the foci were 0.8-3.7 cm. The results of CT plain scan showed that the density of the foci was similar to that of the fat, and the CT value was -101--34 HU. The central density of the foci was lower, while the limbic density was higher. The results of CT enhanced scan showed a ringlike enhancement region in the foci, and the lesion was surrounded by slightly highdensity inflammation. Point or linear slightly highdensity shadows were detected at the center of the foci in 9 patients. The peritoneum was locally thickened in 14 patients. The colonic wall was locally thickened in 1 patient, and the pelvic effusion was detected in 5 patients. The results of CT reexamination of 4 patients showed that the inflammatory regions were reduced or disappeared, the mass shrank, nodulized or calcified.
    Conclusions:MSCT examination can provide a specific features of primary epiploic appendagitis. It could accurately diagnose acute primary epiploic appendagitis when combined with multiplanar reconstruction.

     

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