多排螺旋CT对肠系膜脂膜炎诊断价值

Diagnostic Value of Multi-Slice Spiral CT in Mesenteric Panniculitis

目的:探讨肠系膜脂膜炎患者实施多排螺旋CT检查的临床诊断价值。方法:于2020年1月~2022年12月采集病例资料入档,对象为医院收治的80例疑似肠系膜脂膜炎患者,均实施多排螺旋CT检查,在双盲原则下选择2名具备丰富经验高年资影像科医师判定螺旋CT诊断结果,分析CT影像学特征;对比正常组织和病变组织平扫、增强扫描CT值。结果:80例疑似患者经CT诊断,检出肠系膜脂膜炎72例,检出率为90.00%;CT扫描征象:左中腹肠系膜出现云雾状密度增高影,存在清晰边界,密度不均匀,可见多发小结节样软组织密度影,病变边缘呈脂肪环征与假包膜征;CT诊断结果:41例发现假包膜征,占比56.96%,图像显示肿块周围有软组织密度带,厚度约2~8mm,密度带分隔周围脂肪组织与肠系膜炎症,相比肿块右侧肿块前方与后方包膜相对厚;31例患者发现脂肪环征,占比43.05%,病变组织包绕肠系膜血管,但无侵犯,病变增强扫描强化不明显,内部小结节显示中等程度强化,CT图像显示环状低密度影,为正常脂肪组织,且平扫与增强扫描病变组织CT值无显著差异;病变组织平扫CT值和增强扫描CT值均明显高于正常组织CT值(P<0.05)。结论:肠系膜脂膜炎诊断中应用多排螺旋CT技术,诊断准确率较高,可得到准确病变特征性表现图像,且无创安全,方便快捷,为临床制定合理治疗方案提供可靠依据,故可作为本病优选诊断方式。

Objective:To explore the clinical diagnostic value of multi-slice spiral CT in patients with mesenteric panniculitis.Methods:From January 2020 to December 2022,80 patients with suspected mesenteric panniculitis were enrolled,all of whom underwent multi-slice spiral CT examination.Under the principle of double-blind,2 experienced and senior radiologists were selected to judge the diagnosis results of spiral CT and analyze the imaging characteristics of CT.The CT values of plain scan and enhanced scan were compared between normal tissue and pathological tissue.Results:72 cases of mesenteric panniculitis were detected by CT in 80 suspected patients,and the detection rate was 90.00%.CT scan signs:the left midabdominal mesentery has a cloud-like density enhancement shadow with clear boundary and uneven density,and multiple nodular soft tissue density shadows can be seen,with fat ring sign and false capsule sign at the edge of the lesion;CT diagnosis results:false capsule sign was found in 41 cases,accounting for 56.96%.The image showed that there was a soft tissue density zone around the mass,with a thickness of about 2-8mm,which separated the surrounding adipose tissue from mesenteric inflammation.Compared with the right side of the mass,the capsule in front of and behind the mass was relatively thick.Fat ring sign was found in 31 patients,accounting for 43.05%.The pathological tissue surrounded mesenteric vessels,but it was not invaded.The enhancement of lesions was not obvious,and the internal nodules showed moderate enhancement.CT images showed annular low-density shadow,which was normal adipose tissue,and there was no significant difference in CT values between plain scan and enhanced scan.The CT values of plain scan and enhanced scan of diseased tissues were significantly higher than those of normal tissues(P<0.05).Conclusion:The application of multi-slice spiral CT in the diagnosis of mesenteric panniculitis has high diagnostic accuracy,accurate images of pathological features,non-invasive,safe,convenient and fast,and provides reliable basis for making reasonable treatment plans in clinic,so it can be used as the preferred diagnostic method of this disease.