硬化性肠系膜炎的典型及非典型影像学表现

Typical and Atypical Imaging Features of Sclerosing Mesenteritis

目的:探讨硬化性肠系膜炎的典型及非典型影像学表现,以提高对该病的认识。方法:回顾性分析经临床病理证实的29例硬化性肠系膜炎患者的CT和MRI资料。结果:(1)典型表现(27例):病变均起自肠系膜根部,包绕肠系膜血管,其中15例呈雾状系膜,12例显示假肿瘤征,21例可见假包膜,17例可见脂肪环征。CT平扫表现为肠系膜密度增高,CT值为-66^-38HU,明显高于腹膜后正常脂肪密度(-160^-100HU),差异有统计学意义(P<0.05)。MRI平扫表现病变呈不均匀长T1、长T2信号,假包膜呈等T1、短T2信号。CT、MRI增强扫描病变呈轻度强化,假包膜呈轻度延迟强化。(2)非典型表现(2例):1例表现为肠系膜周围多发小结节,1例表现为肠系膜周围散在钙化灶。结论:硬化性肠系膜炎具有典型和非典型影像学表现,临床与影像学表现相结合有助于提高对本病的诊断。

Purpose： To explore the typical and atypical imaging features of sclerosing mesenteritis, in order to improve the diagnostic accuracy of it. Methods： The imaging data of CT and MRI in 29 cases of patients with sclerosing mesenteritis proved by clinical and pathology results were analyzed retrospectively. Results： （1） Typical manifestations （27 cases） included： the lesions were originated from the mesenteric root and encapsulating the mesenteric blood vessels, the features included misty mesenteries in 15 cases, pseudotumors in 12 cases, tumoral pseudocapsules in 21 cases and fat ring signs in 17 cases. CT plain scan showed high density lesions, with the CT value of mesentery range from -66 - -38HU and were significantly higher than that of the retroperitoneal adipose tissue in the same patients （-160 - -100HU）, the difference was with statistical significant （P 〈 0.05）. Long T1 and T2 signals appeared on MRI, the pseudocapsule manifiested iso-intensity on T1WI and hypo-intensity on T2WI. The mesenteries were slightly enhanced, and the pseudocapsules were slightly delayed enhanced. （2） Atypical manifestations （2 cases） included： multiple nodules surrounded the mesentery in one case, calcification surrounded the mesentery in one case. Conclusion： Sclerosing mesenteritis are with typical and atypical imaging features, combined clinical symptoms with imaging features can improve the diagnosis of the disease.