Morison问隙区域巨大占位病变CT鉴别诊断(附47例分析)

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目的:分析Morison间隙区域巨大占位病变的CT表现特点,探讨其诊断要点。材料和方法:Morison间隙区域8cm以上占位47例,其中肝源性23例,肾上腺源性9例,肾源性10例,后腹膜源性5例。均在Siemens公司Somatom Plus机上行平扫和增强扫描。结果:(1)肝源性占位时,肿块与肝组织界限不清;下腔静脉向左移;胆囊向前内移位。(2)肾上腺源他占位,肿块与肝组织间有一脂肪层间隙;下腔静脉向前内移位,右肾向后下推移且旋转;胆囊向前外推移。(3)肾源性占位,肿块与肝组织间有脂肪层间隙,胆囊移位不明显;下腔静脉向前内移位;肾脏向后下移位无转轴;肿块与肾脏交界处呈“杯口”状。(4)后腹膜源性占位,下腔静脉和肾脏移位方向不定,腰大肌常受侵犯及变形。结论:(1)肿块中心位置与肝脏之间的关系、胆囊和下腔静脉的移位情况以及肾脏有无转轴对肿块的定位诊断具有非常重要的影像意义。(2)肿块内部密度是否均匀,与周围组织器官之间的关系,以及有无向周围侵犯,是鉴别良恶性的关键,囊性占位均为良性。 OBJECTIVE: To analyze the CT features of Morong interstitial space-occupying lesion and discuss the main points of its diagnosis. Materials and Methods: Morison interspaces occupy more than 8cm and occupy 47 cases, including 23 cases of hepatic origin, 9 cases of adrenal gland, 10 cases of renal origin and 5 cases of retroperitoneal origin. Upgraded and enhanced scanning at Siemens Somatom Plus. Results: (1) Hepatic origin occupies a clear boundary between tumor and liver tissue; the inferior vena cava moves to the left; and the gallbladder moves forwards and inwards. (2) Adrenal gland he occupies a lump of fat between the tumor and liver tissue. The inferior vena cava moves forwards and forwards, the right kidney moves backwards and downwards, and the gallbladder moves forward and outward. (3) Nephrogenic space occupying a space between the tumor and the liver tissue with a gap between the fat layer and the gallbladder did not shift obviously; the inferior vena cava shifted forward and backward; Cup mouth "shape. (4) retroperitoneal space-occupying, inferior vena cava and renal transposition direction, often affected by psoas and deformation. Conclusion: (1) The relationship between the center of the mass and the liver, the displacement of the gallbladder and the inferior vena cava and the diagnosis of the location of the kidney by the rotation shaft are very important. (2) whether the internal density of the tumor is homogeneous, the relationship with the surrounding tissues and organs, and the presence or absence of invasion to the surroundings are the keys to differentiate benign from malignant. The cystic spaces are benign.
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