MSCT对原发性肠脂垂炎的检查价值

目的 探讨原发性肠脂垂炎（PEA）的CT特征,MSCT的检查价值.方法 对12例具有完整MSCT扫描资料并随访证实的原发性肠脂垂炎病例进行回顾性分析.12例均行全腹平扫,其中2例行增强扫描.结果 10例病灶位于直乙状结肠转折处,1例位于回盲部,1例位于降结肠；12例卵圆形脂肪密度病灶均可见边缘高密度环,11例病灶中心可见高密度影；9例病灶周围可见继发性炎性改变,其中5例可见邻近腹膜增厚,但均未见邻近肠壁增厚及周围积液；2例增强扫描病灶边缘的高密度环及邻近增厚的腹膜可见强化.4～10周后CT随访,12例病灶均自行消退.结论 边缘高密度环征、中心高密度影和周围继发性炎性改变为原发性肠脂垂炎的特征性CT表现,MSCT能清楚显示病灶细节特征及毗邻结构,对原发性肠脂垂炎的诊断有决定性意义.

Clinical value of MSCT in the diagnosis of primary epiploic appendagitis

Objective To explore the characteristic features of the primary epiploic appendagitis （PEA） in CT and the diagnostic value of multi-slice computed tomography （MSCT） in PEA. Methods A retrospective analysis of 12 patients with PEA proved by follow-up in CT was conducted. No-contrast CT scan was performed in all cases and contrast CT scan was performed in 2 cases. Results 10 lesions were found around rectosigmoid junction, 1 lesion around ileocecal region and 1 lesion around ascending colon. 12 ovoid shaped fatty lesions were all circumscribed by hyperattenuating rings, 11 lesions had central hyperattenuating area. 9 lesions were found secondary inflammatory changes of the fat layer around lesions and 5 were found thickening of the adjacent peritoneal, but there was no thickening of the adjacent bowel wall and effusion around the bowl. 2 cases in contrast CT scan had moderate enhancement of the hyperattenuating rings and the adjacent peritoneum. All lesions disappeared after 4~10 weeks. Conclusion Hyperattenuating ring sign, central hyperattenuating area and secondary inflammatory changes were characteristic features of PEA in CT and MSCT is of great value in the diagnosis of PEA.