心包窦和心包隐窝的螺旋CT表现及其解剖学基础

目的 在横断面解剖学的基础上，评价心包窦、隐窝的横断面螺旋CT表现及其影像学意义。资料与方法 复习52例心包积液（按中－大量组和少量组）和146例无心包疾病（正常对照组）病例纵隔螺旋CT影像，并对照2例尸体横断面解剖，描述心包窦、隐窝在5个主要横断面的显示率，并进行统计学分析。结果 心包各窦、隐窝的显示率均大于40％。心包少量积液组与中－大量积液组心各包窦与隐窝的显示率，以及病例组与对照组间PCR、RPR、pSAR的显示率无显著性差异（P＞0．05）；而病例组与对照组间其余心包各窦与隐窝的显示率有显著性差异（P＜0．05）。结论 心包窦、隐窝在螺旋CT上易于显示。其定位诊断需依靠断层解剖学知识，并应与邻近正常结构及其病变相区别。

Spiral CT Manifestations and Anatomic Basis of Pericardial Sinuses and Recesses

Objective To study the manifestations of the pericardial sinuses on axial spiral CT scans in comparison with sectional anatomy, and to evaluate its imaging significance.Materials and Methods Axial spiral CT findings of the mediastinum in 52 patients with pericardial effusion (effusion group) and 146 subjects without pericardial effusion (control group) were reviewed. Comparing with the sectional anatomy in two cadavers, the display rate of the sinuses and recesses on 5 main axial CT slices was analyzed statistically.Results The display rate of the sinuses and recesses was over 40% and no significant difference was found between small, moderate and large effusion group (P>0.05). No significant difference in the display rate of PCR, RPR and pSAP existed between effusion group and control group (P>0.05), except for the others (P<0.05).Conclusion Pericardial sinuses and recesses can be easily detected on spiral CT scans. The localizing diagnosis is depended on the relative sectional anatomic knowledge. The pericardial sinuses and recesses should be differentiated from the adjacent normal structures as well as diseases.