肠系膜脂膜炎的CT定量影像与分型
Quantitative imaging and classification of mesenteric panniculitis
李文华 1熊瑶 2耿云平 1张毅 2李天然2
作者信息
- 1. 南阳市中心医院 CT影像科,河南 南阳 473000
- 2. 中国人民解放军总医院第四医学中心放射诊断科
- 折叠
摘要
目的 分析肠系膜脂膜炎(mesenteric panniculitis,MP)的定量影像学特点并进行分型,提高对 MP 的影像认识.方法 对64 例 MP 患者的临床和 CT检查数据进行回顾性分析,并根据 CT表现和临床综合诊断将患者分为炎性渗出型、脂肪坏死型和纤维化型.通过对肠系膜病变组织和同层面正常腹膜后脂肪组织进行 ROI勾画和 CT值测量.结果 64 例 MP 患者中 50 例炎性渗出型,8 例脂肪坏死型,6 例纤维化型.病变部位均发生在肠系膜根部,并且向左侧延伸至小肠肠袢,肠系膜脂肪密度增高并出现增生结节.64 例患者中 50 例出现"脂肪环征",56 例出现"假包膜征",37 例同时出现"假包膜征+脂肪环征",9 例同时出现"假包膜征+脂肪环征+血管僵硬、粗细不均".病变肠系膜脂肪密度高于正常腹膜后脂肪组织,MP 区域 CT值为(-55.01±17.88)HU,正常腹膜后脂肪组织为(-99.44±8.67)HU,两者比较差异有统计学意义(P<0.001).不同分型的肠系膜病变 CT 值之间有显著性差异(P<0.001).结论 MP 的 CT表现具有一定的特征性,同时肠系膜病变的 CT 值可作为 MP 分型的依据,有助于临床制定合理治疗方案.
Abstract
Objective To analyze the imaging characteristics and types of mesenteric panniculitis(MP)and im-prove the clinical diagnosis of MP.Methods The clinical and CT examination data of 64 patients with MP were ana-lyzed retrospectively,and the patients were divided into inflammatory exudative type,fatty necrosis type and mild fibros-ing type based on CT features and clinical diagnosis.CT values were measured by ROI outling of mesenteric lesion tissue and normal retroperitoneal adipose tissue at the same level.Results Among the 64 cases of MP,50 cases were inflam-matory exudative type,8 cases were fatty necrosis type,and 6 cases were mildfibrosing type.The lesions all occurred at the mesenteric root and extended to the left side to the small intestine collaterals,and all showed increased mesenteric fat density and hyperplastic nodules.Fifty cases showed as fat ring sign,56 cases showed as false capsule sign,37 cases showed as false capsule sign+fat ring sign,and 9 cases were seen as false capsule sign+fat ring sign+blood vessel stiffness and uneven.The lesion mesenteric fat density was higher than that of normal retroperitoneal adipose tissue,with a CT value of(-55.01±17.88)HU in plain scan and(-99.44±8.67)HU in normal retroperitoneal adipose tissue,and the difference was statistically significant(P<0.001).There was a significant difference in CT values of mesenteric lesions of different types(P<0.001).Conclusion The CT manifestation of MP has certain characteristics,and the CT value of mesenteric lesions can be used as a basis for MP classification,which is helpful to make reasonable clinic treat-ment plan.
关键词
肠系膜脂膜炎/计算机断层扫描/假包膜征/脂肪环征/分型Key words
Mesenteric panniculitis/Computed tomography/Pseudocapsule sign/Fat ring sign/Classification引用本文复制引用
出版年
2024
NETL
NSTL
万方数据