CAJ | 학술논문

目的：探讨腹股沟斜疝少见和特殊征象的多层螺旋CT表现。方法收集19例经手术证实的少见腹股沟斜疝病例，均行多层螺旋CT扫描，其中平扫4例，增强扫描15例，均将原始图像传至工作站行图像后处理，分析影像特点及特殊征像。结果19例中单侧疝12例，双侧7例。巨大疝6例，1例同时见膀胱、肠管、脂肪及腹膜等疝入，另5例疝内容物为肠管、网膜等；少见疝内容物6例，包括膀胱疝入5例，1例为大部分膀胱疝入，表现为肠管及腹膜伴随膀胱一起疝入阴囊；其余为部分膀胱疝入，见膀胱呈“哑铃”状改变；输尿管疝入阴囊1例，表现为迂曲扩张的巨输尿管疝入阴囊，并伴双肾积水。嵌顿疝合并肠梗阻5例，表现为近端肠管扩张积气并出现液－气平面；绞窄性疝2例，增强扫描肠管无强化。结论多层螺旋CT能够正确判断少见腹股沟斜疝的类型，明确疝内容物的种类、大小及周围解剖关系，为少见和特殊腹股沟斜疝的诊断积累影像经验。
목적：탐토복고구사산소견화특수정상적다층라선CT표현。방법수집19례경수술증실적소견복고구사산병례，균행다층라선CT소묘，기중평소4례，증강소묘15례，균장원시도상전지공작참행도상후처리，분석영상특점급특수정상。결과19례중단측산12례，쌍측7례。거대산6례，1례동시견방광、장관、지방급복막등산입，령5례산내용물위장관、망막등；소견산내용물6례，포괄방광산입5례，1례위대부분방광산입，표현위장관급복막반수방광일기산입음낭；기여위부분방광산입，견방광정“아령”상개변；수뇨관산입음낭1례，표현위우곡확장적거수뇨관산입음낭，병반쌍신적수。감돈산합병장경조5례，표현위근단장관확장적기병출현액－기평면；교착성산2례，증강소묘장관무강화。결론다층라선CT능구정학판단소견복고구사산적류형，명학산내용물적충류、대소급주위해부관계，위소견화특수복고구사산적진단적루영상경험。
Objective To discuss the multi-slice CT (MSCT) manifestations in diagnosis of inguinal hernia with rare and special signs. Methods CT images of 19 rare inguinal hernia cases were reviewed,.4 cases with plain scan and 15 cases with enhanced scan..The images were transferred to the workstation and image postprocessing were done to analyze the image characteristics and special signs. Results Among the 19 patients, there were 12 cases of unilateral hernia and 7 cases of bilateral hernia..Of the 6 cases of huge hernia,.the hernia contents were bladder,.bowel,.fat and peritoneum in 1 case and bowel and omentum in 5 cases..There were 6 cases with rare hernial content,.including 5 cases of bladder herniation..CT showed bowel, peritoneum together with bladder,.herniated into the scrotum in 1 case,.while the rest were partial bladder herniation and the bladder showed dumbbell shape on CT image..1 case of ureteral hernia into the scrotum showed the tortuous and dilated megaureter herniation into the scrotum accompanied by bilateral hydronephrosis. .5 cases of incarcerated hernia with intestinal obstruction manifested as expansion and pneumatosis of proximal bowel with gas-liquid plane. .2 cases of strangulated hernia showed no enhancement..Conclusion MSCT can estimate the types of rare inguinal hernia correctly and determine the type ,.size and anatomical relationship of hernial contents..It can provide valuable imaging information for reasonable clinical treatment and prognosis judgment.