胰腺炎并发脾门区及脾脏假性囊肿的CT诊断(附8例报告)

目的：探讨脾门区及脾脏内胰源性假性囊肿形成的解剖学机制及CT诊断价值。方法：收集经手术或临床治疗随访证实的脾及脾门区胰源性假性囊肿8例，对其CT征象进行回顾性分析。结果：8例患者胰尾或胰体尾部发现囊肿，其中5例在随访过程中发现脾内囊肿形成，2例发现脾间囊肿形成；1例单纯发现脾门区囊肿。7例早期均有明确的胰腺炎病史，发病部位以胰体尾为主，囊肿密度早期较高，后期CT值在12HU左右。壁厚薄不一，较大者壁薄。随着囊液的吸收，壁逐渐变厚。脾内囊肿初期表现边界欠清，平均7周左右出现较清晰的边界，结合增强及薄层扫描，有4例脾内囊肿与脾被囊问有明确的裂隙相连通。结论：脾肾韧带及胃脾韧带是脾门区及脾脏内胰源性假性囊肿形成的重要解剖学基础；CT检查对胰腺假性囊肿诊断及其动态监测具有重要临床意义。

CT diagnosis of splenic and splenic hilum pancreatic pseudocyst in pancreatitis(report of 8 cases)

Objective:To explore the anatom ic al mechanism of pseudocystic formation and CT examination value of splenic and s plenic hilus pancreatic pseudocyst in pancreatitis.Methods:Eight cases of splenic and splenic hilu m pancreatic pseudocyst verified by operation or follow-up were included in thi s group.The pseudocysts' CT manifestation were reviewed and their anatomical mec hanism of formation were analyzed by reference of documents.Results:Pseudocysts were found in pancreatic ta io in 7 cases,5 cases among them developed pseudocysts in spleen during follow- up.Pseudocysts between stomach and spleen were found in 2 cases.Only one pseudoc yst at spleenic was found in the case.History of pancreatitis was evident in all 7 cases.Pancreatic body and tail were mainly inclueded.Pseudocysts had relative ly high density at early stage,then the density reduced to 12HU or so at anaphas e.Thickness of the wall of pseudocysts was not the same-the bigger,the thinner. It would become thicker with the absorption of fluid in the pseudocyst.Early mar gins of the pseudocysts were not clear,clear margins were formed at an average p eriod of 7 weeks.Evident fissures connecting splenic capsule and pseudocyst with in spleen were confirmed in 4 cases by analysis of thin slice or contrast enhanc ed CT images.Conclusion:Lienorenal and gastrolienal ligament s were important anatomic basis in the formation of the splenic or splenic hilus pancreatic pseudocysts.CT scan was of important value in the diagnosis and dyna mic monitoring of the pancreatic pseudocysts.