腹部非急性胰腺炎相关性脂肪坏死CT表现及病理分析

发布时间：2018-01-13 20:00

本文关键词：腹部非急性胰腺炎相关性脂肪坏死CT表现及病理分析　出处：《中国CT和MRI杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨腹部非急性胰腺炎相关性脂肪坏死病灶CT征象及其病理基础。方法回顾性分析我院2009年3月至2015年3月间20例无急性胰腺炎病史,术后病理证实为腹部脂肪坏死的住院患者的CT影像资料,观察病灶及周围组织CT表现及强化特征并与病理对照。结果 (1)部位:20患者中16例发生于腹腔,4例发生于腹膜后。(2)CT表现:分为结节型(14/20)、脂质囊肿型(3/20)和网状疏松型(3/20)三种类型,以结节型(14/20)最为常见,结节型和脂质囊肿型病灶局限(最大径均值分别为1.8cm和2.5cm),网状疏松型病灶范围较大(最大径均值8.5cm)。14例结节型病灶中11例出现钙化,其中8例为环形钙化,3例为不规则形钙化;结节型病灶血供不丰富,仅4例轻度强化,10例未见明显强化。脂质囊肿型病灶3例均为薄壁含脂质囊肿(CT值-20HU),其中1例囊壁出现钙化,增强后3例均出现环形强化。网状疏松型3例均表现为混杂脂肪密度,呈边界清晰的网格状结构,无明显钙化,增强后轻度强化。结论腹部非急性胰腺炎相关性脂肪坏死CT表现具有一定特征性,能够反映其病理特征,对病灶的正确诊治具有重要意义。
[Abstract]:Objective to investigate the correlation between acute pancreatitis abdominal fat necrosis lesions CT findings and its pathological basis. Methods Retrospective analysis of our hospital from March 2009 to March 2015 20 cases of acute pancreatitis, postoperative pathology confirmed abdominal fat necrosis in hospitalized patients CT images, to observe the CT manifestations of lesions and surrounding tissues and enhanced features and pathology results: 20 patients (1) site in 16 cases occurred in the abdominal cavity, 4 cases of retroperitoneal. (2) CT: divided into nodular type (14/20), lipid cyst type (3/20) and loose mesh (3/20) with three types of nodular type (14/20) is the most common. Nodular cystic lesions and lipid (the maximum mean diameter is respectively 1.8cm and 2.5cm), loose reticular lesions range larger (maximum mean diameter 8.5cm).14 cases of nodular lesions in 11 cases showed calcification, 8 cases of annular calcification, 3 cases of irregular calcified nodules; Type of blood supply is not rich, only 4 cases of mild enhancement, 10 cases had no obvious enhancement of lipid. 3 cases were cystic lesions of thin lipid containing (CT = -20HU), cyst including 1 cases of cyst wall calcification, enhancement after 3 cases were circular enhancement. Porous mesh type 3 cases showed mixed fat a density grid structure with clear boundary, no obvious calcification, slight enhancement. Conclusion non acute pancreatitis abdominal fat necrosis CT has a certain characteristic, can reflect the pathological characteristics, diagnosis and treatment of disease has important significance.

【作者单位】：南京大学医学院附属鼓楼医院放射科;南京大学医学院附属鼓楼医院病理科;
【分类号】：R576;R816.5
【正文快照】： 5131.2016.04.029脂肪坏死是因各种原因导致脂肪损伤后引起的少见良性非化脓性炎性病变,主要包括酶解性脂肪坏死和创伤性脂肪坏死。脂肪坏死可发生于全身任何部位的脂肪组织中,其中脂肪聚集部位发病率较高,如乳腺、皮下、腹腔及腹膜后等部位。急性胰腺炎发作时胰酶及炎性细胞

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