单纯食管裂孔网膜疝

Simple esophageal hiatus omental herina

目的探讨单纯食管裂孔网膜疝(simple esophageal hiatus omental hernia,SEHOH)的MSCT影像特点。方法回顾性分析7例手术证实的SEHOH,均作了MSCT平扫及增强检查,获取亚毫米数据作MPR及MIP。结果横断位7例均显示食管裂孔(EH)膈上大小不等纯脂肪血管囊,其中呈椭圆形和类圆形各3例,分叶形1例,多位于食管右前方;矢状位表现为心后区铸型脂肪密度影,形态由正中矢状位的半月形或三角形逐渐过渡到旁中央矢状位的三角形或半圆形;冠状位呈椭圆形3例、倒梨形2例和分叶状2例。脂肪血管囊下部呈"狭颈样"与腹腔网膜脂肪连续,上极被撑开的膈食管膜与食管相连成角状。MIP均显示胃左动脉(GLA)主干僵直,食管支附近呈对称"∩"形穿越EH。贲门均位于膈下。结论心后纯脂肪血管囊膨胀性和可塑性形态,紧贴食管并与腹腔网膜相连;GLA主干僵直,食管支附近呈对称"∩"形并穿越EH是SEHOH特征性影像表现,对诊断具有重要意义。

Objective To discusses the characteristic MSCT findings of simple esophageal hiatus omental hernia （SEHOH） .Methods Prospective study was made on 7 cases of SEHOH confirmed by surgery ,all patients were examined by plain and enhanced MSCT scan to make MPR and MIP with sub-millimeter data .Results All 7 cases showed sizes of a pure fat vascular sac above the diaphragmatic esophageal hiatus （EH） on a cross-sectional image ,among which 3 cases presented oval and 3 presented similar round in shape ,1 case showed lobulated ;Most of them located at the right front side of esophagus .On sagittal images ,the sac all displayed casting fat density shadow at postcordial ,and the morphology of the sac raged from half or triangle in the middle of the sagittal image to that of triangle or semicircle in the parasagittal planar ;In the coronal planar images ,the sac displayed oval in 3 cases ,pear-shaped upside-down in 1 case and lobulated in 1 case ,The bottom of the pure fat vascular sac that presented narrow neck shape connected with abdominal omental fat , and the diaphragmatic esophageal membrane that was shoved off in the upper polar of the pure fat vascular sac linked with the esophageal then formed an angle .The whole 7 cases of MIP images showed that the trunk of GLA was stiff on MIP , and it passed through EH with a symmetric ＆quot;∩＆quot;near the esophagus branch .Gastro-esophageal connections were all located under the diaphragm .Conclusion The following findings are characteristically presents of SEHOH ,which are of great importance to imaging diagnosis of SEHOH ：the expansablity ,morphological plasticity ,closed to the esophagus and connected to the abdominal omental of the pure fat vascular sac ,and stiff of the trunk of GLA ,and it passes through EH near the esophagus branch with a symmetric＂∩＂.