肠周脂肪CT征象在诊断肠疾病中的临床价值

Clinic value of CT signs of peri-bowels fat in diagnosing bowel diseases

目的研究肠疾病中肠周脂肪CT征象及其病理基础,探讨肠周脂肪CT征象对诊断肠疾病的价值。方法回顾性分析经手术、病理证实的39例肠疾病患者的术前腹部CT征象,观察原发疾病与肠周脂肪CT征象的关系,并与术中所见和病理结果进行对照分析。结果39例肠疾病患者的肠周脂肪CT征象包括脂肪组织模糊、蚯蚓状影、线状影、结节影、网格状影、积液影、条索状影及脂肪组织结构僵硬,其病理基础包括充血、水肿、渗出,血管扩张、淋巴管炎、淋巴结肿大、组织纤维化、癌肿浸润。术前正确判断良、恶性36例(36/39)。肠恶性肿瘤术前CT诊断肠周淋巴结转移19例(19/20),手术病理证实只有13例(13/20)。结论肠周脂肪对肠疾病的反应敏感,不同肠疾病在肠周脂肪中产生不同的CT征象。

Objective To observe the CT characters of peri-bowels fat tissue with bowels diseases, and to explore it＇s clinical value in diagnosing howels diseases. Methods Abdominal CT images of 39 preoperative cases with bowels diseases con- firmed by pathology were retrospectively studied. The images characters of the lesion and peri-bowels fat tissue were observed, and the relationship between image characters with findings in operation and patho-findings were analyzed. Results The CT signs of peri bowels fat tissues of 39 cases included fatty tissue blur, angle worm sign, line sign, nodule sign, grid sign, fluidify sign, trabs sign and fatty tissue structure stiffness. The patho-findings of peri bowels fat tissues included con- gestion, edema, effusion, vessel expanding, lymphangitis, lymphadenectasis, tissue fibrosis or cancer infiltration. Preoperation exactly judged benign or malignant in 36 of 39 cases. Bowel malignant tumor was diagnosed in 19 cases （19/20） with peri-bowels lymph node metastasis preoperation, but only 13 were confirmed by operation-pathology. Conclusion Peri-bowels fat tissue is sensitive to bowels diseases. The different patho reactions of different bowels diseases results in different CT characters.