肠系膜脂膜炎MSCT影像特征分析

Analysis of the MSCT imaging features of mesenteric panniculitis

目的分析肠系膜脂膜炎(MP)MSCT的表现特征,提高对其诊断的正确率。方法回顾性分析49例MP的MSCT表现特点,按照CT标准并结合临床做出诊断。CT平扫34例,平扫加双期增强扫描15例,并采用1.25mm层厚和1mm重建间隔获得最大密度投影(MIP)和多平面重建(MPR)图像。结果49例病变均位于小肠系膜,包绕肠系膜血管;炎症渗出型47例,CT平扫均呈不均匀脂肪密度,CT值-74^-23HU,明显高于腹膜后正常脂肪密度(-116^-92HU),其中13例增强扫描,病灶无明显强化;脂肪坏死型和纤维化型各1例,表现为脂肪包块内出现肿块,前者为囊性肿块,后者为软组织肿块,增强扫描软组织肿块中度强化,静脉期CT值上升约40HU。49例中,出现“假包膜征”32例,“脂环征”36例,“小结节”21例,肠系膜血管狭窄2例。结论MP的MSCT表现具有特征性,是MP非常有价值的诊断手段。

Objective To analyze the MSCT imaging features of mesenteric panniculitis(MP)so as to improve the diagnostic accuracy.Thus,Methods We retrospectively evaluated the imaging features of MSCT in 49 cases of MP in CT standard and made the diagnosis combined with clinical manifestations.34 cases of MP were subjected to Plain CT scanning and 15 cases of MP to Plain scanning combined with double-phase enhanced scanning.And then,by using 1.25 mm thickness and 1 mm interval reconstruction,the images of multiple planner reconstruction(MPR)and maximum intensity projection(MIP)were obtained.Results All pathological changes in 49 cases were located in the mesentery of small intestine,wrapped around the mesentery vessel;there were 47 cases of inflammation exudative type and the scanning on CT of them usually showed non-uniform fat density.The value of CT ranged from 74 to 23 HU,which was significantly higher than the normal fat density of retroperitoneal(-116^-92 HU)and 13 cases of them underwent the enhanced scanning,the lesions had no obvious intensify;Fat necrosis type and fibrosis type were found in 1 case each,showing a mass within the fat package,the former being a cystic mass and the latter being a soft tissue mass,and soft tissue mass was moderately enhanced by contrast-enhanced scan,and the CT value of venous phase increased by about 40 HU.Among them,32 cases were seen as“false capsule”,36 cases showed as“fat ring”,21 cases showed as“tubercule”and 2 cases were seen as“the mesentery vessel of limited stenosis”.Conclusion MSCT manifestations of MP are characteristic,which is valuable for the diagnosis of MP.