MSCT对原发性肠脂垂炎的检查价值

Clinical value of MSCT in the diagnosis of primary epiploic appendagitis

目的 探讨原发性肠脂垂炎（PEA）的CT特征,MSCT的检查价值.方法 对12例具有完整MSCT扫描资料并随访证实的原发性肠脂垂炎病例进行回顾性分析.12例均行全腹平扫,其中2例行增强扫描.结果 10例病灶位于直乙状结肠转折处,1例位于回盲部,1例位于降结肠；12例卵圆形脂肪密度病灶均可见边缘高密度环,11例病灶中心可见高密度影；9例病灶周围可见继发性炎性改变,其中5例可见邻近腹膜增厚,但均未见邻近肠壁增厚及周围积液；2例增强扫描病灶边缘的高密度环及邻近增厚的腹膜可见强化.4～10周后CT随访,12例病灶均自行消退.结论 边缘高密度环征、中心高密度影和周围继发性炎性改变为原发性肠脂垂炎的特征性CT表现,MSCT能清楚显示病灶细节特征及毗邻结构,对原发性肠脂垂炎的诊断有决定性意义.

Objective To explore the characteristic features of the primary epiploic appendagitis （PEA） in CT and the diagnostic value of multi-slice computed tomography （MSCT） in PEA. Methods A retrospective analysis of 12 patients with PEA proved by follow-up in CT was conducted. No-contrast CT scan was performed in all cases and contrast CT scan was performed in 2 cases. Results 10 lesions were found around rectosigmoid junction, 1 lesion around ileocecal region and 1 lesion around ascending colon. 12 ovoid shaped fatty lesions were all circumscribed by hyperattenuating rings, 11 lesions had central hyperattenuating area. 9 lesions were found secondary inflammatory changes of the fat layer around lesions and 5 were found thickening of the adjacent peritoneal, but there was no thickening of the adjacent bowel wall and effusion around the bowl. 2 cases in contrast CT scan had moderate enhancement of the hyperattenuating rings and the adjacent peritoneum. All lesions disappeared after 4~10 weeks. Conclusion Hyperattenuating ring sign, central hyperattenuating area and secondary inflammatory changes were characteristic features of PEA in CT and MSCT is of great value in the diagnosis of PEA.