多层螺旋CT用于肠系膜脂膜炎诊断84例临床回顾性分析

Clinical retrospective analysis of multi-slice spiral CT in the diagnosis of mesenteric panniculitis in 84 cases

目的探讨多层螺旋CT用于肠系膜脂膜炎的诊断价值。方法回顾性分析我院2012年1月—2021年12月诊治的84例肠系膜脂膜炎患者的影像学资料,观察CT扫描图像,分析其钙化、囊变、脂肪环征、假包膜征、淋巴结增大、纤维组织结节、假肿瘤等影像学特征,统计正常脂肪组织和肠系膜病变的CT值,以及CT诊断的灵敏度和特异性。结果所有患者的病变部位均在肠系膜,单发62例、多发22例,均有假包膜征,改变周围可见软组织密度区,边界较浅,包膜大部分延伸至左腰区,呈现前后较厚、右侧较薄;肠系膜病变组织的CT值为(-60.43±7.33),腹膜后正常脂肪组织的CT值为(-102.63±7.84),数据比较差异有统计学意义(t=33.026,P<0.05);77例患者的影像学特征可见于脂肪环内,被包块、食管内淋巴结或纤维组织周围的肠血管周围的低环状密度阴影所包围;1例钙化、1例囊改变;77例患者的病灶表现为不规则带状、淋巴结增多、环状纤维结节;26例患者的周围肠管被推移;CT诊断阳性率为91.7%(77/84),诊断阴性率为8.3%(7/84),特异性为9.2%(7/76),灵敏度为100%(8/8)。结论多层螺旋CT扫描在肠系膜脂膜炎的诊断中呈现出假肿瘤、假脂肪环性质和假包膜性质,诊断率较高,建议作为诊断肠系膜脂膜炎的无创性首选检查方案。

Objective To explore the diagnostic value of multi-slice spiral CT in mesenteric panniculitis.Methods The imaging data of 84 patients with mesenteric panniculitis diagnosed and treated in our hospital from January 2012 to December 2021 were retrospectively analyzed,the CT images of patients were observed,and the imaging features of calcification,cystic change,fat ring sign,pseudo-peritoneal sign,enlarged lymph nodes,fibrous tissue nodules and pseudotumor were analyzed.Results All patients’lesions were located in the mesentery,62 cases of single and 22 cases of multiple,all of them had the pseudo-peritoneal sign,and the soft tissue density area was seen around the changes,with shallow borders,and most of the peritoneal membrane extended to the left lumbar region,presenting anterior and posterior thicker,right side thinner;the CT value of mesenteric lesion tissues was(-60.43±7.33)HU,and that of normal retroperitoneal adipose tissues was(-102.63±7.84)HU,the difference was statistically significant when comparing the data(t=33.026,P<0.05);The imaging features of 77 patients can be seen in the fat ring,surrounded by mass,intraesophageal lymph nodes or low ring density shadow around intestinal vessels around fibrous tissue.1 case of calcification and 1 case of cystic changes occurred sign;77 cases showed irregular bands,increased lymph nodes and annular fibrous nodules.Peripheral intestines were displaced in 26 patients;CT had a positive diagnostic rate of 91.7%(77/84),the negative diagnostic rate of 8.3%(7/84),the specificity of 9.2%(7/76),and the sensitivity of 100%(8/8).Conclusion Multi-slice spiral CT scanning presents a high diagnostic rate in mesenteric panniculitis in terms of pseudotumor,pseudo-fat ring and pseudo-peritoneal sign and is recommended as a noninvasive preferred examination for diagnosis of mesenteric panniculitis.