腹部巨大囊性病变CT诊断

CT diagnosis of the giant cystic lesions in abdomen

目的 :探讨腹部巨大囊性病变的CT诊断和鉴别诊断要点。方法 :腹部巨大囊性病变 3 0例 ,均经手术病理证实 ,分析其病变中心点、边界、囊壁、分隔、钙化、液平征、强化等要素。结果 :中下腹包块 14例 ,有 15个包块。其中 :卵巢浆液性囊腺瘤 4例 ,5个包块。粘液性囊腺瘤 3例 ,卵巢囊肿 1例 ,卵巢—输卵管炎性囊肿 1例 ,巨大膀胱憩室 1例 ,成熟性囊性畸胎瘤 4例 ;中上腹包块 13例 ,其中 :囊性淋巴管瘤 5例 ,肠重复畸形囊肿 2例 ,小网膜囊内神经鞘瘤囊性变 1例 ,胆总管囊肿 3例 ,非胰腺性假性囊肿 2例 ;腹膜后包块 3例 ,有胰腺假性囊肿 1例 ,重度肾积水 2例。结论 :腹部巨大囊性病变绝大多数为良性 ;包块中心点位于中下腹者以女性附件疾患发病率最高 ;囊性淋巴管瘤在腹部囊性病变中占有一定比例 ,并且腹膜后发病也不少见。

Objective:To study CT diagnosis and differential diagnosis of the giant cystic lesions in abdomen.Methods:30 cases of the giant cystic lesions were confirmed by surgery and histopathology.The center of the lesion,attenuation,thickness of cystic wall and septa,calcification,fluid fluid level sign and contrast enhancement were analyzed.Results:14 cases of giant cystic lesions in the central lower part of abdomen include 4 cases of ovarian serous cystadenoma,3 ovarian mucinous cystadenoma,1 ovarian simple cystic,1 tubo ovarian inflammatory cyst,1 giant bladder diverticulum and 4 cystic teratoma.13 cases of cystic mass in the central upper part include 5 cases of cystic lymphangioma,2 intestinal duplication,1 giant cystic schwannoma in omental bursa,3 common bile duct cyst and 2 peritoneal pseudocyst.3 cases of retroperitoneal mass included 1 pancreatic pseudocyst and 2 giant hydronephrosis.Conclusion:Most of the giant cystic lesions in abdomen are benign.Overian cystadenoma is the most common.Cystic lymphangioma,retroperitoneal cystic mass and others should also be considered in differential diagnosis.