脐尿管憩室伴结石1例MSCT表现及鉴别诊断并文献复习

MSCT manifestations and differential diagnosis of urachus diverticulum with calculi and literature review

目的探讨脐尿管憩室伴结石患者的MSCT影像学表现特点及鉴别诊断,提高对该疾病的认识。方法收集1例经手术、病理证实的脐尿管憩室伴结石患者的MSCT影像资料,数据在ADW4.4工作站进行矢状位及冠状位重建,并结合相关文献进行回顾性分析。结果脐尿管憩室伴结石病变位于近腹中线,脐与膀胱之间的Retzius间隙内;MSCT表现为膀胱前顶壁脐尿管走行区可见狭长囊腔与膀胱相通,囊壁光滑,囊腔内可见葫芦状高密度影,大部分位于膀胱腔内,小部分突出膀胱轮廓外。结论脐尿管憩室伴结石位于近腹中线,脐与膀胱之间的Retzius间隙内。结合观察MPR的矢状位重建及轴位图像具有较好的应用价值。MSCT能够明确病变的部位、形态、范围及其与邻近组织结构的关系,提高对脐尿管病变的诊断和鉴别诊断的能力。

Objective To explore MSCT expression characteristics and differential diagnosis of urachus diverticulum with calculi, and to improve the understanding of the disease. Methods Collected the MSCT imaging data of 1 urachus di-verticulum with calculi patient who was confirmed by operation and pathology. Data in ADW4.4 workstation accepted sagittal and coronary reconstruction, and was analyzed retrospectively combined with related literature. Results Urachus diverticulum with calculi lesions were located near the belly line, Retzius interstice between the umbilicus and urinary bladder. MSCT performed that the long and narrow lumen was interlinked with bladder at urachal direction of the ahead hanging wall of bladder , the cap-sule wall was smooth, gourd shape high density shadow could be seen in the lumen, most in the bladder lumen, less outside the outline of the bladder. Conclusion Urachus diverticulum with calculi is located near belly line, Retzius interstice between the umbilicus and urinary bladder. MPR of sagittal reconstruction combined with axial images has good application value. MSCT can specify the location, shape, scope of the lesion and its relationship with adjacent tissue structure, improve the diagnosis of urachal lesions and the ability of differential diagnosis.