多排螺旋CT诊断小网膜囊病变的价值

Diagnostic value of multi-detector CT for abnormalities in lesser omental bursa

目的探讨小网膜囊正常解剖及病变的多排螺旋CT(MDCT)表现,评价小网膜囊病变的CT诊断价值。方法对24例小网膜囊病变进行上腹部CT平扫及三期增强扫描检查,均经手术病理证实。结果小网膜囊病变中:原发肿瘤6例(神经鞘瘤2例,平滑肌瘤1例,血管瘤1例,脂肪肉瘤1例,淋巴瘤1例),CT表现为小网膜囊内边界清晰肿块。邻近脏器的良、恶性肿瘤8例(胰头癌4例,肝左叶肝细胞癌2例,胃间质瘤2例),CT表现为小网膜囊肿块与邻近相应肿瘤边界不清。转移性肿瘤2例。结核1例,CT表现多个病灶融合,内见钙化。积液(腹水漏出液、炎性渗出液、脓液、血液、胆汁、淋巴液)6例;假性囊肿1例;CT均表现为小网膜囊内液性密度灶。结论多排螺旋CT对小网膜囊病变具有重要的诊断价值。

Objective To investigate the normal CT anatomy and diagnostic value of CT for abnormalities of lesser omental bursa. Methods Twenty-four patients with 6 primary neoplasms （2 neurinomas, 1 leiomyoma, 1 cavernous hemangioma, 1 liposarcoma, 1 lymphoma） ,8 local spread from adjacent beni^gn or malignant neoplasms （4 carcinomas of head of pancreas, 2 left hepatic tumors, 2 gastrointestinal stromal tumors of the stomach）, 2 metastatic tumors, 1 tuberculosis, 6 fluid collections （transudate ascites, inflammatory infiltrate, pus, blood, bile, lymph）, lpseudocyst were enrolled in the study. All of the lesions were confirmed by operation and pathology. The pre- and post-contrast abdominal CT scans were reviewed. Results The borders of the 6 primary neoplasms were well-defined on CT whereas the 8 benign or malignant neoplasms originating from adjacent structures were contiguous with the primary tumors. CT showed multiple aggregated lesions on 2 patients with metastases and 1 patient with tuberculosis. The 6 fluid collections and lpseudocyst displayed fluid density within lesser omental bursa on CT. Conclusion CT is valuable in diagnosing abnormalities of the lesser omental bursa.