腹腔肿瘤的CT表现

目的：旨在进一步提高对腹腔脓肿ＣＴ表现的认识。材料和方法：经手术证实的腹腔肿瘤１５例，回顾性分析腹腔脓肿的ＣＴ表现。结果：１１例中央呈均匀低密度影及由低密度勾画出的壁，占７３％；内壁光，外壁毛糙分别为８例、１０例，分别占７２％、９０％，增强后壁强化程度明显高于软组织。腔内含气影７例，占４６％。脓肿邻近脏器界面显示模糊１０例，占６６％。腹腔脂肪呈索条状、片状、网格状密度增高９例，占６０％。腹壁炎性改     

腹腔脓肿的CT诊断价值评估

目的：分析腹腔脓肿的CT表现，进一步提高腹腔脓肿的CT诊断水平。方法：对22例患者其中29个腹腔脓肿的CT表现进行回顾性分析。结果：19(66％)个病灶见脓肿壁有均匀强化的不规则厚壁，厚度约为0．1～1．0锄；12(41％)个脓肿内见到少量气体影或气液平面；所有病例均未见到钙化。结论：CT对腹腔脓肿定位诊断准确，均匀完整的脓肿壁强化和内部见到含气征象具有一定的特征性。     

腹腔脓肿的CT诊断价值

目的 分析腹腔脓肿的CT表现,进一步提高腹腔脓肿的CT诊断水平。资料与方法 对22例患者中29个腹腔脓肿的CT表现进行回顾性分析。结果 19（66％）个脓肿壁为均匀强化的不规则厚壁,厚度约为0.1～1．0cm;12（41％）个脓肿内见到少量气体影或气-液面;所有病例均未见到钙化。结论 CT对腹腔脓肿定位诊断准确,均匀完整的脓肿壁强化和内部见到含气征象具有一定的特征性。     

输卵管卵巢脓肿影像学表现及误诊分析

目的：总结输卵管卵巢脓肿的影像学表现,探讨该病影像学诊断价值并分析误诊原因。方法回顾性分析13例术后病理确诊或临床确诊输卵管卵巢脓肿影像学资料,4例行 CT 平扫,9例行 MRI 平扫及增强(其中5例同时行超声检查),并与病理结果对照。结果10例表现为附件区腊肠样病变(其中1例超声误诊为肠梗阻),CT 平扫呈均匀低密度影,MRI 平扫呈长/短 T1长T2信号、部分可见液-液平面形成,增强扫描脓肿壁轻度增厚并明显均匀强化,所有患者表现不同程度腹腔、盆腔积液及周围筋膜增厚;3例表现为单侧附件区厚壁多房囊实性包块(其中2例术前误诊为卵巢肿瘤性病变),增强扫描表现为厚壁及分隔明显强化。结论CT 及 MRI 对腊肠样表现的输卵管卵巢脓肿诊断的特异性及敏感性较高,多能做出定性诊断,对囊实性病灶能清楚显示,但定性诊断困难,误诊率较高。     

脾脓肿的CT表现

目的:探讨脾脓肿的好发部位以及不同病理阶段脾脓肿的CT表现.材料和方法:回顾性分析8例脾脓肿的临床资料及CT表现.结果:进展期脾脓肿7例,CT平扫表现为病灶密度较正常脾实质低,增强扫描表现为脓肿灶边界清晰,内可见低密度区中有迂曲细线样增强影;晚期脾脓肿1例,CT平扫表现为完全液化、边界清晰的低密度影,内有气体影,增强扫描囊壁有环形增强.共25个脓肿灶,其中4个位于脾门区,8个位于中间区,13个位于周围区.结论:脾脓肿好发于中间区及周围区,且在不同病理阶段的CT表现各不相同,结合临床可明确诊断.     

颈深筋膜间隙感染的影像学诊断

目的 探讨影像学在颈深筋膜间隙感染的诊断价值.方法 回顾性分析47例颈深筋膜间隙感染的影像学表现.结果 单间隙受累24例,多间隙受累23例.蜂窝织炎17例,脓肿30例.蜂窝织炎CT表现为软组织肿胀,边界不清,增强扫描呈弥漫性强化;MRI蜂窝织炎呈弥漫性长T1长T2信号.脓肿CT表现为局限的低密度病灶,可有气体密度影,增强扫描脓肿壁呈环形强化,脓液不强化,MRI中脓肿呈明显长T2信号影,脓肿壁在T1WI及T2WI呈中等或者低信号;并发症9例,与无并发症组比较,脓肿、多间隙感染、多间隙脓肿发生例数增高;颈动脉间隙、椎周间隙、脏器间隙感染更容易出现并发症.结论 影像学检查在颈深筋膜间隙感染诊断及治疗中有重要价值.     

螺旋CT诊断和鉴别诊断急性右下腹疼痛的价值

目的评估螺旋CT诊断和鉴别诊断急性右下腹疼痛的价值.材料和方法回顾性分析35例经病理证实的急性右下腹疼痛病变的CT表现.结果18例阑尾炎中,CT表现阑尾增粗,壁增厚,周围脂肪索条8例,含粪石4例、含气体3例;并发阑尾周围脓肿10例,CT表现回盲部轮廓不清的类圆形或不规则软组织团块影,中心呈低密度,脓肿壁呈环状或蜂窝状增强.阑尾粘液囊肿2例,CT均表现为盲肠阑尾区类椭圆形囊状低密度影,CT值为3～8Hu,边缘清晰锐利,壁较薄,局部弧线样钙化,无增强.盲结肠憩室炎1例,CT表现盲结肠增粗,肠壁增厚,边缘模糊,小气泡,分层增强.盲、结肠克隆病1例,CT表现盲肠及升结肠不对称性、节段性肠壁增厚,CT值23 Hu,肠腔轻度狭窄,肠壁增强.盲、升结肠癌10例,CT平扫表现不规则软组织密度,呈不均匀增强,肠壁不规则增厚,肠腔不规则狭窄,壁结节.卵巢平滑肌瘤1例,CT表现右下腹一卵圆形软组织密度肿块,CT值46～58Hu,轻度增强;卵巢纤维瘤2例(右侧1例,左侧扭转到右侧1例),CT表现为软组织密度肿块,CT值33～50Hu,伴点弧形状钙化,无明显增强.结论螺旋CT诊断和鉴别诊断急性右下腹疼痛病变具有较高价值,为首选的影像学检查方法.     

外伤性脾破裂的CT诊断（附3O例分析）

目的：本文对30例外伤性脾破裂进行了分析总结，评价CT在诊断中的价值。结果：CT表现以脾实质内不均质低密度影多见。脾周新月形低密度影是脾破裂腹腔内积血的常见CT征象。同时伴有肝、肾、肋骨、脊柱等多发损伤。结论：本组CT诊断脾破裂无1例假阳性。     

输卵管卵巢脓肿的CT诊断价值

目的 总结分析女性输卵管卵巢脓肿的CT特征，以寻求和探讨鉴别诊断依据及CT诊断的价值。方法 回顾性分析10例输卵管卵巢脓肿患者CT腹盆腔增强扫描资料。结果 10例患者CT均显示附件区厚壁囊性或囊实混合性肿块，肿块外缘模糊毛糙，增强多见脓肿壁呈厚壁分层强化及内部强化分隔。其他伴随的CT表现：子宫骶骨韧带增厚9例，直肠周围、骶前脂肪密度增高模糊9例，显示输卵管扩张积脓或积液的管状结构影6例，宫腔积液4例。CT观察到脓肿与盆腔结构粘连包括：肿块与子宫粘连者9例，与直肠、乙状结肠粘连者4例，与盆腔小肠肠管及盆壁结构广泛粘连3例；显示腹膜增厚伴腹水及右侧输卵管卵巢脓肿伴阑尾炎各2例。结论 CT除了能观察附件区囊实性肿块，还能显示相邻盆腔器官的受累粘连及盆底软组织或筋膜层的炎性浸润，能对附件脓肿做定性和定位诊断，对诊断不清的可疑妇科感染有鉴别价值。     

少儿小脑肿瘤CT征象分析（附21例报告）

目的分析少儿小脑肿瘤的CT特征,并评价其鉴别诊断意义。方法 21例经手术病理证实小脑肿瘤（18例原发和3例转移瘤）患儿均经CT平扫与增强扫描。对全部患儿的CT表现进行了回顾性分析。结果原发性星形细胞瘤12例,CT平扫多表现为边界不清的低密度影,其中,囊性变10例（83.8%）,伴发壁结节8例（66.7%）,增强后,囊壁轻度强化9例。原发性血管母细胞瘤4例,CT平扫表现为混杂密度影,其中,2例呈囊性变伴壁结节,增强后,囊壁与壁结节呈中度以上强化。原发性髓母细胞瘤2例,分别表现为囊性和混杂密度影,其中1例伴灶内钙化,增强后,囊壁明显强化。转移瘤3例,CT平扫表现为边界不清的低密度影,增强后呈不规则形或环状强化,其中2例出现瘤周水肿。结论不同类型的少儿小脑肿瘤其CT征象或强化形式有一定差别,可为鉴别诊断提供重要信息。     

Seminal vesicle abscesses: Spectrum of computed tomographic findings

The computed tomographic (CT) findings in four cases of seminal vesicle abscess are presented. The predominant infectious organism in two cases wasEscherichia coli, one case was probably caused byMycobacterium tuberculosis, and another by atypical mycobacterium. The CT findings included unilateral (three cases) or bilateral involvement (one case), seminal vesicle enlargement with hypodense areas within the gland (three cases), adjacent perivesicle inflammation (three cases), and associated bladder wall thickening (three cases). Although the diagnosis of seminal vesicle abscess is often overlooked clinically, CT may help suggest the correct diagnosis early thereby helping to initiate therapy.     

Seminal vesicle abscesses: spectrum of computed tomographic findings

The computed tomographic (CT) findings in four cases of seminal vesicle abscess are presented. The predominant infectious organism in two cases was Escherichia coli, one case was probably caused by Mycobacterium tuberculosis, and another by atypical mycobacterium. The CT findings included unilateral (three cases) or bilateral involvement (one case), seminal vesicle enlargement with hypodense areas within the gland (three cases), adjacent perivesicle inflammation (three cases), and associated bladder wall thickening (three cases). Although the diagnosis of seminal vesicle abscess is often overlooked clinically, CT may help suggest the correct diagnosis early thereby helping to initiate therapy.     

Computed tomography in the evaluation of diverticulitis

Computed tomography (CT) was performed in 43 cases of colonic diverticulitis and compared with the contrast-enema examination (CE) in 37 patients. Findings on CT included inflammation of the pericolic fat in 98% of cases, diverticula in 84%, thickening of the colon wall in 70%, a pericolic abscess in 35%, peritonitis in 16%, a fistula in 14%, colon obstruction in 12%, and intramural sinus tracts in 9%. Secondary findings included a distant abscess in 12% and ureteral obstruction in 7%. In addition to detecting ureteral and bladder involvement and distant abscess formation, CT was preferable for demonstrating the extent of pericolic inflammation, which was underestimated with CE in 41% of patients. Differential diagnosis of the CT findings is discussed. The authors indicate that CT should be the initial procedure in patients with suspected diverticulitis, particularly when CE is contraindicated.     

The role of spiral computed tomography in sigmoid diverticulitis and the diagnostic-therapeutic implications

PURPOSE: Colonic diverticula are saccules made of colonic mucosa and submucosa that herniate from the colonic lumen through the muscular layer of the wall where straight vessels penetrate. Diverticula are localized in the sigmoid colon in 95% of cases. Bacteria pooling in the lumen may cause lumen erosion and eventually perforation. CT is a useful technique in this condition because it can demonstrate intra- and/or extramural inflammation. Aim of this retrospective study was to assess the capabilities of contrast-enhanced helical Computed Tomography (CT) in sigmoid diverticulitis, especially relative to selection of the appropriate treatment. MATERIAL AND METHODS: We retrospectively reviewed the findings of 41 patients referred to our emergency department for diverticulitis. CT scans were performed 65 seconds after i.v. injection of nonionic contrast material (3 mL/s, 120 mL in all) administered by a CT-power injector. The following 7 CT findings were considered at least suggestive of acute diverticulitis: focal wall thickening, intramural abscess, inflammatory changes in the sigmoid mesentery root, pericolic fat inflammation or pericolic abscess formation, fistula, peritonitis. CT results were compared with surgical and physical findings. RESULTS: Based on CT findings, diverticulitis was classified as mild (25 patients) or severe (15 patients). In mild diverticulitis we found: focal sigmoid wall thickening (6 patients), intramural abscess (3 patients), sigmoid mesentery root thickening (5 patients), edema fluid (8 patients) and phlegmon (3 patients). In severe diverticulitis we found: sigmoid mesentery abscess (6 patients), fistula (5 patients) and peritonitis (4 patients). CT findings were questionable in 1 case and thus we could not exclude a perforated carcinoma. CONCLUSION: Contrast-enhanced helical CT is the imaging modality of choice in assessing mild or severe acute diverticulitis because it provides useful information for appropriate treatment planning in the emergency setting. This technique is most useful in questionable cases and in patients with suspected severe diverticulitis where a choice must be made between different treatment options.     

Role of computed tomography in the diagnosis of rib and lung involvement in tuberculous retromammary abscesses

OBJECTIVE: To assess the role of computed tomography (CT) in the diagnosis of rib and lung involvement in tuberculous abscess in the retromammary region. DESIGN AND PATIENTS: Eight patients with tuberculous retromammary abscess were examined by CT and the findings were evaluated. A cold abscess (purulent collection with absence of acute inflammation) was aspirated in all cases. Diagnosis was confirmed by acid-fast bacillus culture, or histologic examination. RESULTS: CT showed a relatively well marginated, inhomogeneous, hypodense lesions in all eight cases. Following administration of intravenous contrast medium, these lesions showed enhancing walls, suggestive of an infective collection. Lung involvement was seen in one patient. A direct communication from the retromammary lesion through the thoracic wall into the pleura was seen in five cases. In four cases destroyed rib fragments within the abscess were noted. CONCLUSION: A tuberculous abscess in the retromammary region is usually shown on CT as a focal, well-marginated, inhomogeneous, hypodense lesion with a surrounding enhancing rim. A direct communication with the pleura, a destroyed rib fragment in the abscess, and associated lung involvement may be revealed by CT.     

Small bowel diverticulitis - Spectrum of CT findings and review of the literature

PurposeTo review the CT findings and complications of small bowel diverticulitis (SBD) and discuss clinical presentations and outcomes.MethodsA text search of radiology reports within our health system for cases of small bowel diverticulitis yielded 95 cases. All cases were reviewed by an abdominal radiologist with equivocal cases reviewed by a second abdominal radiologist for consensus. Retrospective analysis of CT imaging findings was performed on 67 convincing cases of SBD.ResultsSmall bowel diverticulitis most often affected the jejunum (58%) and the duodenum (26%). The most common imaging feature was peridiverticular inflammation manifested by peridiverticular edema, diverticular wall thickening, bowel wall thickening, and fascial thickening. Edema was typically seen along the mesenteric border of the bowel with relative sparing of the anti-mesenteric side. When a prior CT was available, the affected diverticulum was identified in 95% of cases. Fecalized content within the affected diverticulum was observed in 51% of cases. Perforation (6%) and abscess (6%) were the most common complications.ConclusionSmall bowel diverticulitis is an uncommon cause of abdominal pain which can mimic an array of abdominal pathologies, although the reported mortality rate of 40–50% may no longer be accurate. The “fecalized diverticulum” sign can be helpful in identifying the culprit diverticulum and aid diagnosing SBD. Findings of perforation and or abscess formation are critical as they may impact management.     

螺旋CT对急性阑尾炎的诊断价值

目的：探讨螺旋CT对急性阑尾炎的诊断价值。方法：搜集CT提示或诊断为阑尾炎并经手术病理证实的34例患者，回顾性分析其CT征象。结果：15例CT表现为阑尾增粗，壁增厚；26例表现为右下腹或盆腔炎性改变（如周围脂肪密度增高、肠周积液、蜂窝织炎、脓肿、腔外气体、淋巴结肿大、相邻肠管增厚、阑尾结石或粪石）；6例盲肠末端有局限性增厚；4例右侧腰大肌影模糊。结论：CT诊断急性阑尾炎有独到之处，能为临床合理治疗提供帮助。     

肝内胆管脓肿的CT诊断

目的 :探讨肝内胆管脓肿的CT诊断和鉴别诊断。方法 :回顾性分析经临床、病理证实的 2 7例肝内胆管脓肿患者的CT表现及临床资料。结果 :2 7例均可见肝脓肿及胆源性病变表现。肝脓肿CT平扫表现为低密度肿块 ,单发圆形(8例 )、多房或簇状 (9例 )或不规则多发 (10例 ) ,增强扫描示脓肿实质部分明显强化 ,呈“肿块缩小征”6例 ,“周围充血征”8例 ,“簇状征”9例 ,“环靶征”仅 4例。胆源性病变CT表现包括胆管扩张、胆管壁增厚并明显强化 ,胆道积气及胆道结石等。结论 :CT扫描可发现肝脓肿及胆道病变 ,是临床诊断肝内胆管脓肿最可靠的影像学方法。