原发性肠脂垂炎的CT表现及临床意义

目的 分析原发性肠脂垂炎（PEA）的CT特点及临床应用价值.方法 回顾性分析2008年5月～2013年7月经诊断为PEA的完整资料.主要分析肿块的部位、大小、形态、密度及周围情况.结果 肿块位于乙状结肠旁10例,回盲部旁6例,升结肠旁2例,降结肠旁2例,结肠肝曲旁1例.肿块呈圆形、椭圆形.肿块大小1.0cm×1.1cm～2.8cm×3.2cm,平均2.1cm×2.4cm.CT表现早期3例,脂肪肿块内有云絮状高密度,边缘较薄环壁,增强后环壁轻度强化,肿块内絮状、条索状强化.进展期12例,肿块内高低混杂密度,环壁较厚,边缘清楚,环壁中等强化.恢复期6例,肿块缩小,形态不规则,壁变薄,环壁轻度强化.12例进展期中,周围系膜肿胀12例,附近结肠壁轻度增厚5例,小肠袢受压2例,周围淋巴结肿大4例.21例PEA中,9例经手术病理证实,12例影像学检查,并随访病变缩小或消失.结论 CT对PEA的定性诊断有重要价值,对指导临床治疗有重要意义.

The CT manifestation and clinical significance of primary epiploic appendagitis

Objective To analyze the primary epiploic appendagitis （PEA） of the CT features and clinical application.Methods Retrospective analysis of 2008 May to 2013 July,diagnosed as PEA complete information.The main analysis of tumor location,size,shape,density and the surrounding situation.Results The tumor is located next to the sigmoid colon in 10 cases,Ileocecal side in 6 cases.The ascending side in 2 cases,and 2 cases of descending colon,hepatic flexure of the colon in 1 case by.The tumors were round,oval.Tumor size of 1.0 cm× 1.1 cm～2.8 cm× 3.2 cm,2.1 cm× 2.4 cm average.CT manifestations of 3 cases of early,fat mass in cloudy high density,the thinner rim ring wall,enhanced ring wall enhancement,mass within the floc,cord like enhancement.12 cases of advanced stage tumor,mixed high and low density,ring wall thick,clear edge,ring wall secondary reinforcement.6 patients were in recovery period,reduce mass,irregular shape,wall thinning,ring wall enhancement.12 cases of advanced stage,12 cases of peripheral membrane swelling,5 cases of colon wall near the mildly thickened,2 cases of small intestinal loop compression,enlarged lymph node in 4 cases.In 21 cases of PEA,9 cases were confirmed by operation and pathology,12 cases of imaging examination,and follow-up of disease to shrink or disappear.Conclusion PEA has important value in qualitative diagnosis of CT,and has important significance for clinical treatment.