原发性肠系膜占位性病变的CT定位诊断

目的　评价CT扫描在原发性肠系膜占位性病变定位诊断中的价值。方法　 3 5例经CT检查并手术病理证实的原发性肠系膜占位性病变 ,分析其CT定位征象。结果　CT定位正确率 62 .9% ;阳性预测值 78.6%。有助于定位的征象包括 :(1)病灶与肠管关系密切 ,病灶周围有肠管绕行且绕行的肠管位置较恒定 ,而管腔内一般无充盈缺损征 ,本组 2 5例 ;(2 )腹膜后主要脏器受前方病灶压迫而变形、轴位旋转 ,本组 15例 ;(3 )病灶与腹膜后脏器之间及与腹壁之间存在脂肪间隙 ,本组 11例 ;(4 )病灶后缘压迫腹部大血管根部或病灶后缘有大血管包绕现象 ,本组 9例。病灶较大CT定位正确率较低。结论　CT扫描对原发性肠系膜占位性病变的定位诊断有重要价值。结合多种检查结果及临床表现有助于提高诊断正确率

CT Localized Diagnosis of Primary Mesenteric Occupancy Lesions

Objective To evaluate the value of CT examination in localized diagnosis of primary mesenteric occupancy lesions.Methods CT findings in 35 cases of primary mesenteric occupancy lesions proved operatively and pathologically were analysed.Results Accuracy and postive forecast rate of localization of lesions by CT were 62.9% and 78.6% respectively.The findings of localized diagnosis included:(1)The relation between the occupancy lesions and intestines was closed,the situs was circled by intestines which were fixed and there was no filling defect in 25 cases.(2)The main retroperitoneal organs were distorted and their axes were rotated by the lesions in 15 cases.(3)There was fat space between the lesions and the retroperitoneal organs and the abdomen walls in 11 cases.(4)The main blood vessels of abdomen were compressed by the lesions or the lesions circled by vessels in 9 cases.The localized accuracy was lower when the lesions were larger.Conclusion CT is useful for localization of primary mesenteric occupancy lesions.CT combined with other imaging data and clinical symptoms can improve CT localized accuracy.