MSCT对原发性肠脂垂炎的诊断价值

目的探讨多层螺旋CT（MSCT）对原发性肠脂垂炎（PEA）的诊断价值方法回顾性分析17例临床随访证实的PEA的MscT表现，主要分析病灶的部位、大小、形态、密度、边界及与周围结构的关系结果病灶位于乙状结肠旁9例，回盲部6例，结肠肝曲2例病灶大小1．5cm×2．Ocm-3Ocm×5．Ocm，平均直径约2．Ocm×4．Ocm；2例病灶表现为肠壁边缘圆形或卵圆形稍高密度影，15例表现为肠壁边缘戒指样或环形稍高密度影，中央可见点状较高密度影，周围可见少许条索影病灶周围边界均不清楚15倒局部腹膜稍增厚，并受牵拉轻微凹陷；l例局部肠壁稍增厚、水肿改变；2例结肠旁沟及盆底少量积液。保守治疗2-4周CT复查，患者临床症状及腹部包块消失而确诊本病结论PEAMSCT表现具有一定特征性，结合临床表现及MscT资料容易作出诊断，并指导临床治疗，避免不必娶的手术治疗，

Objective To investigate the diagnostic value ofmusti-slice spiral computed tomography （ MSCT ） in PEA. Methods This study was retrospective, with Mainly analysis of the MSCT manifestation of 17 patients with PEA confirmed by clinical follow-up. Focus was put on the location, size, shape, density, boundary and the relationship with surrounding structures of the lesions. Results 9 lesions located next to colon sigmoideum, 6 lesions situated in ileocecal region, and 2 lesions around hepatic flexure of bowel. The sizes of the lesions ranged from 1.5cm ~ 2.0cm to 3.0cm x 5.0cm, average diameter is 2.0cm x 4.0cm. 2 lesions show round or ovoid and 15 lesions show ring like or annular high density shadow on the edge of the bowel wall, the centre of the lesion present punctilbrm higher density shadow, and the funicular shadow can be seen around the lesions, all the boundary of the lesions are obscure. 15 lesions were found with thicken peritonaeum, and were concave by slight wation. 1 lesion were found with thicken and edema bowel wall, 2 lesions were found with a small amount of effusion in paracolic sulci and pelvic. All the lesions were confirmed to PEA according to tile disappearance of the symptoms and abdominal mass aider 2-4weeks conservative treatment. Conclusion PEA possesses characteristic manifestation in MSCT, it is easy to make a dignosis combined with clinical features and to guide the clinical treatulent, avoiding unnecessary surgery.