CAJ | 학술논문

目的探讨多层螺旋CT检查对不典型腹内疝的诊断价值.方法对手术证实的16例不典型腹内疝的临床及CT资料进行回顾性分析.结果 16例患者的疝内容物均为小肠及其系膜结构;继发于腹部手术或腹腔感染后粘连致内疝者9例,肠系膜裂孔疝6例,盆底腹膜裂孔疝1例.主要CT表现为:(1)梗阻的小肠肠袢异常聚集,成簇状排列(9例)；小肠肠壁增厚、水肿,呈“靶环征”伴周旁间隙渗出(5例)；病变区域以外腹腔出现肠管空虚征象(4例).(2)肠系膜血管走行异常,包括肠系膜聚集、牵拉、僵直改变,肠系膜血管主干左、右移位(12例)；肠系膜血管增粗(4例)；肠系膜扭转,表现为“旋涡征”(3例).(3)经CT多平面重组后可显示疝环所在(5例),疝环区可见聚集、拉长僵直、再度扇形放射状走形的肠系膜血管,与成簇状排列的积液扩张多个肠袢相互构成“降落伞征”或“成束气球征”.结论不典型腹内疝的CT表现具有一定的特征性,对临床诊断有重要价值.
목적 탐토다층라선CT검사대불전형복내산적진단개치.방법 대수술증실적16례불전형복내산적림상급CT자료진행회고성분석.결과 16례환자적산내용물균위소장급기계막결구;계발우복부수술혹복강감염후점련치내산자9례,장계막렬공산6례,분저복막렬공산1례.주요CT표현위:(1)경조적소장장번이상취집,성족상배렬(9례)；소장장벽증후、수종,정“파배정”반주방간극삼출(5례)；병변구역이외복강출현장관공허정상(4례).(2)장계막혈관주행이상,포괄장계막취집、견랍、강직개변,장계막혈관주간좌、우이위(12례)；장계막혈관증조(4례)；장계막뉴전,표현위“선와정”(3례).(3)경CT다평면중조후가현시산배소재(5례),산배구가견취집、랍장강직、재도선형방사상주형적장계막혈관,여성족상배렬적적액확장다개장번상호구성“강락산정”혹“성속기구정”.결론 불전형복내산적CT표현구유일정적특정성,대림상진단유중요개치.
Objective To discuss the value of mutiple-slice spiral CT diagnosis of atypical intraabdominal hernia.Methods The clinical and CT findings of 16 cases of atypical intraabdominal hernia confirmed surgically were retrospectively analysed.Results In all the 16 cases,the contents of hernia were small bowels and the mesentery.Nine cases were caused by the adhesion after abdominal operations or infection,6 by the mesenteric foramen,and 1 by the gap of pelvic peritoneum.The main CT findings were as follows:(1)the obstructed small bowels gathered abnormally and showed cluster shape(9 cases) ; the walls of the bowels thickened with edema and showed "target" sign with exudate in the neighboring spaces (5 cases); other part of the abdominal cavity became empty for lack of small bowels (4 cases).(2) Abnormal arrangement of the branches of mesenteric vessel,which appeared gathered or pulled or rigid and displacement of the main branches to left or right ( 12 cases).Thickened mesenteric vessel (4 cases):torsion of mesentery with "whirlpool" sign (3 cases).(3) With the help of multiplanar reformation,5 cases showed the evidence of hernia rings.In the ring area,there were gathered or pulled or rigid and radiating mesenteric vessel and the dilated or effusion bowels in cluster arrangement forming "parachute" and "bundle of balloons" sign.Conclusion CT manifestations of atypical intraabdominal hernia has some specific characteristics,which is of important value for clinical diagnosis and treatment.