肠系膜脂膜炎MSCT影像学表现

Multi-slice spiral CT findings of mesenteric panniculitis

目的分析肠系膜脂膜炎的MSCT特点,提高CT诊断及鉴别诊断的水平。方法回顾性分析12例肠系膜脂膜炎的临床及MSCT表现。5例CT平扫,7例CT平扫加双期增强检查,12例均按照CT诊断标准诊断为肠系膜脂膜炎(1例手术证实)。结果 12例表现为围绕肠系膜根部及走形区域边界清楚的脂肪肿块,呈云雾状密度增高影。7例增强扫描病灶未见强化,病变与腹腔内脂肪和腹膜后脂肪分界清晰。9例可见"假包膜"征,6例见"脂肪环"征。6例病变对邻近肠袢有推移征象,其中1例导致小肠梗阻,1例病变伴门静脉及肠系膜上静脉部分栓塞。3例病变内及后腹膜见小结节。12例病变肿块内均无囊性变及钙化灶。结论肠系膜脂膜炎CT表现具有一定特征,MSCT是诊断肠系膜脂膜炎非常有效的影像手段。

Objective To analyze the characteristic of mesenteric panniculitis on multi-slice spiral CT examination and to enhance the awareness of this disease. Methods The clinical and CT image data were retrospectively analyzed in 12 pa- tients with mesenteric panniculitis. 5 patients were examinated by CT plain scan, 7 patients received enhanced,all patients with mesenteric panniculitis which were diagnosed according to the CT crietria （1 case had histopathologic results）. Re- salts 12 cases of fat masses presented with clear boundary around mesenteric root and mesenteric distribution area, ap- peared as a cloud shaped increased density of the mesostenium. 7 cases of CT enhancement scan were not enhanced, the fat masses were sharpy defined with abdominal and retroperitoneal fat. ＂False capsule＂sign were seen in 9 cases,＂fat ring＂sign were observed in 6 cases. 6 cases had signs of adjacent bowel compression and displacement, including 1 case led to small howell obstruction, 1 case presented with portal vein and superior mesenteric vein partial embolization. Small lymph nodes in the masses and retroperitoneum in 3 cases were seen. Cystic degeneration and calcification were not seen in all cases. Conclusion Certain features of the CT manifestations of mesenteric panniculitis can be found, MSCT is effective for the diagnosis of mesenteric panniculitis.