CT定位诊断腹腔内卵巢源性和小肠系膜源性囊性病变的价值

目的探讨螺旋CT对腹腔内卵巢源性和小肠系膜源性囊性病变的定位诊断价值。资料与方法回顾性分析18例临床资料和CT资料完整的卵巢源性和小肠系膜源性囊性病变,均经手术病理证实。着重观察肿块与十二指肠水平段的关系、肠系膜上血管有无移位、系膜血管有无包绕、生殖血管有无增粗、肿块有无卵巢血管蒂,以及肿块的后方有无空肠和回肠等。结果(1)5例小肠系膜囊性病变中,肿块上缘位于十二指肠上缘上方层面3例,肠系膜上血管移位4例,系膜血管包绕4例,肿块后方无空/回肠5例。(2)13例卵巢源性病变中,肿块上缘位于十二指肠上缘上方层面5例,肠系膜上血管移位4例,一侧生殖静脉增粗8例,卵巢血管蒂征显示8例,病变后方显示空/回肠11例。结论依据观察肿块上缘与十二指肠上缘的关系,肠系膜血管有无包绕,生殖血管有无增粗,卵巢血管蒂征的有无,肿块后方有无空肠和回肠显示等征象,以及肿块的CT特点,可对腹腔内卵巢源性和小肠系膜源性囊性病变作出定位诊断。

The Value of CT in Localizing Ovarian and Mesenteric Cystic Masses

Objective To probe the value of spiral CT in the localization diagnosis of ovarian and mesenteric cystic masses in the peritoneal space.Materials and Methods 18 cases of ovarian and mesenteric cystic masses proved by surgery and pathology were included in this study.All cases underwent contrast enhanced CT scan.Emphasis was placed on the following findings:(1) Relationship of masses with the third part of the duodenum,the mesenteric vessel,and the jejunoileum.(2) display of gonadal veins and "ovarian vascular pedicle" sign.Results Among 5 cases of ovarian masses,3 masses located at the superior border of the third part of duodenum.4 cases showed cencasement of the meseteric vessels and shift of the superior mesenteic vessels.5 cases did not show jejunoileum in the rear of the masses.Among 13 cases of mesenteric masses,5 masses located at the superior border of the third part of duodenum.4 cases showed the shift of the superior mesenteic vessels.8 cases displayed the engorgment of the unilateral gonadal veins and the "ovarian vascular pedicle" sign.11 cases showed jejunoileum in the rear of the masses.Conclusion The CT appearances,including the relationship of masses with dudenum,the mesenteric vessel and the jejunoileum,display of gonadal veins and "ovarian vascular pedicle" sign,are helpful for the localization diagnosis of ovarian and meseteric cystic masses in the peritoneal space.