摘要
目的探讨分析不典型肠系膜囊肿(MC)的CT影像表现特点与临床特征,以提高对该病的认识和诊断水平。方法对收治的7例经病理证实为不典型肠系膜囊肿的CT资料、病理及临床特征进行分析,其中包括巨大肠系膜囊肿3例,肠系膜囊肿并出血2例,肠系膜囊肿伴感染2例,观察其CT影像特征与临床、病理特点的表现进行相关性分析。结果CT上主要表现为腹腔内肠外囊性灶,3例巨大囊性病灶,几乎占据腹腔,囊壁菲薄,边界清,无壁结节;复杂囊肿4例,囊内合并出血及囊壁增厚伴感染各2例,其中囊肿伴感染表现为囊内密度略增高,周围边界模糊,囊壁增厚,增强后囊壁强化;囊肿伴出血表现为囊腔内高密度影,增强扫描内容物都无强化。正确诊断2例,误诊5例,其中误诊为卵巢囊腺瘤2例,脓肿1例,腹膜后神经源性肿瘤1例及畸胎瘤1例。误诊原因主要是缺乏对不典型肠系膜囊肿CT表现的认识,忽略了囊肿来源与外因等因素所致。结论不典型肠系膜囊肿有不典型CT表现,易误诊。注意管观察病灶来源及周围脏器情况,加之增强扫描可显著提高CT定性诊断的准确性。
Objective To expore the CT and clinical features of atypical mesenterium cyst so as to improve the dignostic accuracy and understanding of the disease. Methods The CT images features of 7 cases with atypical mesenterium cyst confirmed by surgery and pathological examination were retrospectively analyzed,and compared with the pathologic results,including enormous mesenterium cyst（ n = 3）,mesenterium cysts associated with infection（ n = 2） and mesenterium cysts complicated with bleeding（ n = 2）. Results The principle CT manifestation of them appeared as cystic mass inside the abdominal cavity outside the bowel with well-defined edge. Among enormous mesenterium cyst（ n = 3）,almost occupied all abdominal cavity,thin and uniform wall without tubercle. Among them,2 mesenterium cysts were associated with infection,CT showed increase in intracystic density and indistinct margms,the cyst wall was thick and enhanced after CT constrasted. 2 mesenterium cysts complicated with bleeding appeared as high density. On contrast CT images,all content of lesions had no significant enchancement. Of 7 cases,2 was diagnosed,5 was proved to be misdiagnosed as cystoadenoma（ n = 2）,abscess（ n = 1）,neurogenic tumor（ n = 1） or teratoma（ n =1）. The main reasons for the misdiagnosis were due to the lack of the knowledge in the imaging features of the disease and due to paying little attention to the characteristic sign of origin and extrinsic factor. Conclusion Atypical mesenterium cyst is an atypical CT sign,which can easily cause misdiagnosis. When great attention is paid to the sign of origin,around organ and contrast enhancement scanningqualitative diagnosis by CT will be significantly improved.
出处
《医学影像学杂志》
2016年第4期687-690,共4页
Journal of Medical Imaging
