腹直肌肿块的CT影像分析及鉴别诊断

发布时间：2018-02-10 04:46

本文关键词： 腹直肌病变转移瘤脓肿体层摄影术 X线计算机　出处：《放射学实践》2016年08期 　论文类型：期刊论文

【摘要】：目的:分析腹直肌肿块的CT表现,探讨CT诊断思路和要点。方法:对55例经病理证实的腹直肌肿块的CT表现进行回顾性分析。全部病例均行64层螺旋CT平扫及增强扫描,由2位放射科医师结合症状和病史,共同分析肿块的CT影像特征。结果:1韧带样瘤13例:以青年女性多见(11/13),7例有剖宫产史,4例为肿瘤术后复发。大部分病灶(10/13)呈梭形与腹直肌长轴平行,平扫呈等或稍低密度,增强呈明显强化。2血管瘤2例:病灶密度不匀,增强呈延迟强化,可见钙化及血管影各1例。3子宫内膜异位7例:均有剖宫产史。病灶为实性4例,囊实性3例,其中1例可见病灶内出血;增强后肿块实性部分强化较明显。4局灶性肌炎1例。病灶边界不清,密度不均,增强呈不规则强化。5脓肿9例:7例为非特异性脓肿(其中3例为切口感染),2例为特异性脓肿(结核性脓肿)。平扫显示病灶边界不清,有中心坏死区和/或气体影,增强后呈环形或不规则强化。6血肿3例:均有腹部创伤史。病灶呈梭形,边界光整,平扫呈高密度1例、等低混杂密度2例,增强后无强化,1例边缘见新生血管影。7转移瘤20例:均有恶性肿瘤病史。16例手术后患者中合并多处转移12例,其中4例为腹直肌切口转移;4例未行手术者除腹直肌转移外合并多处转移。病灶密度欠均匀、可见不规则坏死灶18例,增强扫描呈环形强化。结论:腹直肌肿块的类型多样,结合临床症状及病史,并对CT表现进行细致观察和分析,能较准确地进行定性诊断。
[Abstract]:Objective: to analyze the CT findings of rectus abdominis mass, and to discuss the main points of CT diagnosis. Methods: the CT findings of 55 cases with pathologically proved rectus abdominis mass were retrospectively analyzed. All cases were performed 64-slice spiral CT plain scan and enhanced CT scan. Combined with symptoms and medical history by two radiologists, Results among the 13 cases of ligamentoid tumor of 1: 11 / 13, 7 cases had history of cesarean section and 4 cases had recurrence after operation. Most of the lesions presented spindle shape parallel to rectus abdominis longaxis, plain scan showed isosensity or slightly lower density, most of the lesions were parallel to the long axis of rectus abdominis. 2 hemangioma showed obvious enhancement in 2 cases: the density of the lesion was uneven, the enhancement was delayed enhancement, calcification and vascular shadow were seen in 1 case and 3 cases in each case, 7 cases had a history of cesarean section, the focus was solid in 4 cases, cystic solid in 3 cases. One case had intracerebral hemorrhage, one case had focal myositis with solid partial enhancement of mass after enhancement, the boundary of the lesion was not clear, and the density was uneven. Enhancement showed irregular enhancement of 5 abscesses in 9 cases (7 cases of non-specific abscess) (3 cases of incision infection and 2 cases of specific abscess (tuberculous abscess). Plain scan showed unclear boundary of lesion with central necrotic area and / or gas shadow. There were 3 cases of hematomas with circular or irregular enhancement after enhancement: all had a history of abdominal trauma. The lesions were fusiform, borderline smooth, high density on plain scan in 1 case, and equal low mixed density in 2 cases. There were 20 cases of neovascularization metastases in 1 case without enhancement after enhancement: 12 cases were complicated with multiple metastases in 16 cases with history of malignant tumor after operation, 12 cases were complicated with multiple metastases, 12 cases were complicated with multiple metastases, 12 cases were complicated with multiple metastasis. In 4 cases of rectus abdominis incision metastasis, 4 cases without operation were accompanied with multiple metastases except rectus abdominis. The density of lesions was uneven, and irregular necrotic foci were found in 18 cases. Conclusion: the types of rectus abdominis masses are various. Combined with clinical symptoms and medical history and careful observation and analysis of CT findings, qualitative diagnosis can be made more accurately.
【作者单位】：广东省开平市中心医院放射科;中山大学附属第一医院医学影像科;广东省佛山市南海区人民医院放射科;
【分类号】：R445.2;R735

【相似文献】