摘要
目的探讨脐尿管病变的CT表现及其临床诊断价值。方法回顾分析23例经手术病理证实的脐尿管病变的CT表现,包括病灶部位、形态、大小、增强以及Retzius间隙影像改变。结果全部23例脐尿管病变均位于腹中线处Retzius间隙内的脐尿管走行区。1例脐尿管未闭CT显示阴性。2例单纯性脐尿管囊肿表现为椭圆形或长条状囊性病灶,囊壁光整,囊内密度均匀,增强后无强化。5例脐尿管囊肿伴感染者表现为形态类似的囊性块影,壁厚强化明显,另3例病灶呈多房状,2例呈均匀软组织块影,伴感染之10例在灶周Retzius间隙内均见多少不等的片絮状或索条状密度增高影。7例脐尿管肿瘤均位于中线位膀胱顶壁区,呈不规则软组织肿块状,增强后强化明显4例,轻度强化2例,无明显强化1例。3例膀胱脐尿管憩室伴结石表现为横贯膀胱壁内外的高密度影,另1例伴发脐下脐尿管囊肿感染。结论由于其独特的解剖部位,术前脐尿管病变很容易为CT识别,当脐尿管囊肿合并感染呈均质软组织块时需与脐尿管肿瘤相鉴别。
Objective To analyze CT manifestations of urachal abnormalities and to evaluate its clinical diagnostic value. Methods CT findings of 23 cases of urachal abnormalities proven by surgery and pathology were retrospectively reviewed, the emphasis was focused on its location, shape, size, enhancement-pattern and radiological features in Retzius space. Results All urachal abnormalities were located in the median line of Retzius space alone the course of the urachus(n = 23). There was no positive CT finding in 1 case of patent urachus(n = 1 ). Simple urachal cyst appeared as a homogeneous fluid-filled cavity with thin wall and no enhancement after the intravenous administration of contrast agency ( n = 2 ). Five cases of infected urachal cyst manifested as cysts with thickening and enhanced wall ( n = 5 ) , 3 cases as multi-cyst lesion (n = 3 ) and 2 cases as homogeneous mass (n = 2). Some patch and strip appeared in Retzius space surrounding the lesions in these cases(n = 10). The urachus neoplasms in 7 cases manifested as irregular soft-tissue masses in the midline of the apex of the bladder,with marked enhancement in 4 cases (n=4), mild enhancement in 2 cases(n =2) and no enhancement in 1 case(n = 1). Three cases of urachal diverticulum accompanied with calculus appeared as intramural high-density lesions protruding into the bladder and the Retzius space simultaneously, 1 case with infected urachal cyst below umbilicus. Conclusion Due to its special anatomic position, urachal abnormalities could be easily identified on CT preoperatively, but urachal cyst might mimic urachal tumor when infected sometimes. Familiarity with the anatomical basis and the CT features of urachal abnormalities would facilitate to establish the preoperative diagnosis correctly.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第12期1303-1307,共5页
Chinese Journal of Radiology