多层螺旋CT对皮肤及皮下病变的诊断价值

The diagnostic value of multi-slice computer tomography on cutaneous and subcutaneous lesions

目的探讨多层螺旋CT(MSCT)对皮肤及皮下病变的诊断价值。方法回顾性分析经手术病理证实的16例皮肤及皮下病变的CT资料并复习相关文献。结果 5例皮脂腺囊肿表现为密度不均的软组织影,内有高密度及脂类更低密度区。4例皮肤癌,其中2例基底细胞癌表现为密度均匀肿块。2例恶性黑色素瘤表现为软组织肿块,边缘不规整,与周围组织分界欠清,内密度不均,其中1例中央可见片状稍高密度影。3例皮下脓肿表现为等低混杂密度影,内低密度影可见多房分隔。2例皮下反应性淋巴增生,平扫表现为类椭圆形结节影,增强扫描内不均匀强化,可见小带状明显强化区。2例皮样囊肿表现为皮下密度不均低密度影,周围可见包膜形成。结论 MSCT扫描结合临床资料对皮肤及皮下病变有一定的诊断价值,确诊仍需依靠病理学检查。

Objective To explore the diagnostic value of multi-slice computer tomography （MSCT） on cuta- neous and subcutaneous lesions. Methods Retrospectively analyze the computer tomography （CT） data of 16 patients, who was diagnosed with cutaneous and subcutaneous lesions by the histological examination and surgery, and then review related literature accordingly. Results Five cases with sebaceous cyst showed the uneven density of soft tissue shadow, including high density and lower lipid density area. Of 4 cases with skin cancer, there were 2 cases with basal cell carcinoma characterizing uniform density mass, and 2 cases with malignant melanoma characterizing soft tissue mass, irregular and vague boundary, and uneven density. There was 1 case with malignant melanoma showed sheet slightly high density shadow in the center. 3 cases with subcutaneous abscess showed equal and low density mass shadow, and low density shadow was visible within separated muhilocular characteristic. 2 cases with subcutaneous reactive lymphoid hyperplasia were scanned for oval nodular shadow, and showed uneven strengthening with small ribbon reinforced region by enhancement scanning. 2 cases with dermoid cyst showed subcutaneous uneven and low density shadow and the envelope forming around them. Conclusion MSCT scanning combined with clinical data has diagnostic value on cutaneous and subcutaneous lesions, and definite diagnosis still rely on the pathologic examination.