CAJ | 학술논문

目的分析42例成人Bochdalek疝的CT表现，以提高对本病的认识。方法 42例均系在胸、腹部常规CT扫描中发现膈肌后上方有致密块影，后膈有局部缺损，膈上、下致密影通过膈肌缺损相连而诊断。其中男25例，女17例，平均年龄64岁，71.4%≥60岁。结果 42例中共有53个Bochdalek疝，其中11例为双侧，左侧21例，右侧10例。膈肌缺损最大横径自0.5～6.7 cm，中位数2.8 cm。疝的最大横径自1.5～9.0 cm，中位数3.7 cm，与膈肌缺损大小密切相关（rs=0.72,P＜0.01）。91%病例的CT上均可见有慢性肺部疾病。结论成人Bochdalek疝不少见，CT能准确判断膈肌缺损的位置、疝的大小及其内容物。年龄及慢性肺部疾病对本病的形成有重要作用。
목적분석42례성인Bochdalek산적CT표현，이제고대본병적인식。방법 42례균계재흉、복부상규CT소묘중발현격기후상방유치밀괴영，후격유국부결손，격상、하치밀영통과격기결손상련이진단。기중남25례，녀17례，평균년령64세，71.4%≥60세。결과 42례중공유53개Bochdalek산，기중11례위쌍측，좌측21례，우측10례。격기결손최대횡경자0.5～6.7 cm，중위수2.8 cm。산적최대횡경자1.5～9.0 cm，중위수3.7 cm，여격기결손대소밀절상관（rs=0.72,P＜0.01）。91%병례적CT상균가견유만성폐부질병。결론성인Bochdalek산불소견，CT능준학판단격기결손적위치、산적대소급기내용물。년령급만성폐부질병대본병적형성유중요작용。
Objective　To analyse the CT findings of Bochdalek hernia in adult.Methods　The CT scan of 42 cases were reviewed showing a mass abutting the upper surface of the diaphragm, the defect was located in the posteromedial aspect of hemidiaphragm with continuity of subdiaphragmatic and supradiaphramatic densities through the diaphramatic defect. Among these, 25 cases were male and 17 cases female. The average age was 64 years, 71.4%≥60 old.Results　53 Bochdalek hernias were identified in 42 cases, 11 cases were bilateral, 21 cases were on the left and 10 cases were on the right side. The diaphragmatic defects diameter ranged 0.5～6.7 cm, the median was 2.8 cm. The range of Bochdalek hernias diameter was 1.5～9.0 cm, with median of 3.7 cm. There was a significant association between diaphragmatic defects and size of hernias (rs=0.72,P＜0.01). Chronic pulmonary disease was detected in 91% patients during CT scans.Conclusion　Adult Bochdalek hernia is not a rare condition, CT scan can accurately identify the location, size of diaphragmatic defect and content of hernia. The age and chronic pulmonary disease play an important role in the formation of this hernia.