不典型肠系膜囊肿的CT表现与病理分析

发布时间：2018-10-17 11:41

【摘要】：目的探讨分析不典型肠系膜囊肿(MC)的CT影像表现特点与临床特征,以提高对该病的认识和诊断水平。方法对收治的7例经病理证实为不典型肠系膜囊肿的CT资料、病理及临床特征进行分析,其中包括巨大肠系膜囊肿3例,肠系膜囊肿并出血2例,肠系膜囊肿伴感染2例,观察其CT影像特征与临床、病理特点的表现进行相关性分析。结果CT上主要表现为腹腔内肠外囊性灶,3例巨大囊性病灶,几乎占据腹腔,囊壁菲薄,边界清,无壁结节;复杂囊肿4例,囊内合并出血及囊壁增厚伴感染各2例,其中囊肿伴感染表现为囊内密度略增高,周围边界模糊,囊壁增厚,增强后囊壁强化;囊肿伴出血表现为囊腔内高密度影,增强扫描内容物都无强化。正确诊断2例,误诊5例,其中误诊为卵巢囊腺瘤2例,脓肿1例,腹膜后神经源性肿瘤1例及畸胎瘤1例。误诊原因主要是缺乏对不典型肠系膜囊肿CT表现的认识,忽略了囊肿来源与外因等因素所致。结论不典型肠系膜囊肿有不典型CT表现,易误诊。注意管观察病灶来源及周围脏器情况,加之增强扫描可显著提高CT定性诊断的准确性。
[Abstract]:Objective to analyze the features and clinical features of CT in atypical mesenteric cyst (MC) in order to improve the understanding and diagnosis of the disease. Methods the CT data, pathological and clinical features of 7 cases of atypical mesenteric cyst confirmed by pathology were analyzed, including 3 cases of giant mesenteric cyst, 2 cases of mesenteric cyst with hemorrhage, 2 cases of mesenteric cyst with infection. The correlation between CT imaging features, clinical and pathological features was analyzed. Results on CT, there were 3 large cystic lesions in the abdominal cavity, almost occupied the abdominal cavity, the wall of the cyst was thin, the boundary was clear and there was no wall nodule, 4 cases of complex cyst, 2 cases of intracystic hemorrhage and 2 cases of cystic wall thickening with infection. The cysts associated with infection showed a slight increase in the density of the cysts, blurred peripheral boundaries, thickening of the cyst wall, enhancement of the posterior wall of the cyst, and hemorrhage of the cyst accompanied by high density image of the cysts, with no enhancement of the contents of enhanced scanning. 2 cases were correctly diagnosed and 5 cases were misdiagnosed, including 2 cases of ovarian cystadenoma, 1 case of abscess, 1 case of retroperitoneal neurogenic tumor and 1 case of teratoma. The main causes of misdiagnosis were the lack of understanding of the CT manifestations of atypical mesenteric cysts and the neglect of the origin and external causes of the cyst. Conclusion atypical mesenteric cyst has atypical CT manifestations and is easy to be misdiagnosed. The accuracy of qualitative diagnosis of CT could be significantly improved by observing the origin and surrounding organs of the lesion and enhanced scanning.
【作者单位】：广东省汕头市第二人民医院放射科;
【分类号】：R572.3;R816.5

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