正常横结肠系膜的多排螺旋CT表现及其解剖学基础

MDCT manifestations of normal transverse mesocolon and anatomic basis

目的:结合正常横结肠系膜活体解剖,探讨正常横结肠系膜多排螺旋CT表现特点。方法:①收集41例行腹部增强CT扫描而无横结肠系膜病变的连续性病例,分别观察记录:中结肠血管及胃结肠干的显示,横结肠系膜位置、横结肠系膜脂肪组织密度、横结肠系膜位置、横结肠系膜淋巴结的显示和横结肠系膜的优势显示断面。②观察6例行上腹部手术而无横结肠系膜病变的病例,在术中分别观察记录:横结肠系膜与胰腺的解剖关系、横结肠系膜血管的分布和走行情况。结果:①中结肠动脉显示率93.0%(38/41);胃结肠干显示率100%(41/41);中结肠静脉显示率85.0%(35/41);横结肠系膜轴位/冠状位/矢状位上表现为点状/短条状血管影/条状血管影;横结肠系膜脂肪组织密度均匀,与小肠系膜脂肪组织密度一致;横结肠系膜根部7.0%(3/41)见有淋巴结显示,均为单个淋巴结,直径均<5mm。②术中观察横结肠系膜解剖,发现于横结肠系膜根部,横结肠系膜前后两层包绕胰腺;横结肠系膜血管均附着于横结肠系膜的后层。结论:MDCT可充分显示横结肠系膜的解剖细节。

Objective： Combining general anatomy to investigate the multiple-detector spiral CT （MDCT） manifestations of the normal transverse mesocolon. Materials and Methods： ①CT scan were performed in 41 consecutive patients. Emphasis was placed on the following findings： manifestation of major mesenterie vessels in the transverse mesocolon; location of the transverse mesocolon; fat within the transverse mesocolon; lymph nodes of the transverse mesocolon; the best manifestation level. ②To observe normal transverse mesocolon in 6 patients who had gastric surgery and get emphasis, the following data as： the location of the mesenteric vessels in the transverse mesocolon; the right origin of the transverse mesocolon were noticed. The data of patients＇ age and sex were obtained. Results： ①The revealing rate of middle colic artery was 93.0%（38/ 41）, the middle colic vein was 85%（35/41）, the gastrocolic trunk was 100%（41/41）. On axial MDCT images, the transverse mesocolon appeared as the vessels on the level of the transverse colon under the gastric-colic ligament. It appeared as the vessel net behind the gastro-colic ligament if the transverse mesocolon was oblique, and on the sagittal scans, it appeared as the transverse vessels behind the transverse colic ligament. The attenuation of fat located within the transverse mesocolon was homogenous, the transverse mesocolon was located in the upper and middle abdomen. Eighteen cases showed the small bowel upon the midportion of transverse colon. In 3（7.0%） cases, the normal lymph nodes were revealed in the root of the transverse mesocolon. （②Through general anatomy, pancreas was located in the middle of the two layers of the transverse mesocolon, and the vessels were located on the posterior layer. Conclusion： MDCT can demonstrate the details of the transverse mesocolon.