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目的 分析肠系膜肿块的CT表现 ,探讨CT对其定位、定性及鉴别诊断的价值和限度。资料与方法 对经手术、病理、活检等证实的 1 8例肠系膜肿块的CT表现 ,结合其手术病理及部分超声所见进行回顾分析。选用窗宽 30 0～ 40 0HU、窗位 0HU观察病灶及其邻近肠系膜。结果 1 8例肠系膜肿块中 ,1 6例发生在小肠系膜 (回肠 1 5例 ,空肠 1例 ) ,升、横结肠各 1例。其中恶性淋巴瘤 6例 (非霍奇金病 5例 ,霍奇金病 1例 ) ,淋巴管瘤、炎性假瘤各 3例 ,转移瘤 2例 ,血管外皮细胞肉瘤、平滑肌肉瘤、纤维瘤、单纯囊肿各 1例。除 2例淋巴瘤和 1例转移瘤呈多个肠系膜肿块 ,部分病例伴有腹膜后肿块 ,其余病例均呈孤立性肿块 (此为唯一的CT表现 )。肿块推压肠管 ,部分被肠管包绕 ,邻近肠系膜模糊。“三明治”征多见于恶性淋巴瘤。结论 CT对肠系膜肿块有较大的诊断价值 ,结合病变的解剖、病理基础以及超声特征等 ,术前多可做出提示性甚至正确的定位、定性诊断。对少数难以确诊的病例 ,应行CT导引下穿刺活检确诊
Objective To analyze the CT manifestations of mesenteric masses and investigate the value and limits of CT in its localization, qualitative and differential diagnosis. Materials and Methods The CT findings of 18 mesenteric masses confirmed by surgery, pathology and biopsy were retrospectively analyzed in combination with their surgical pathology and partial sonography. Select the window width 30 0 ~ 40 0HU, window level 0HU observation lesion and its adjacent mesentery. Results In 18 mesenteric masses, 16 cases occurred in the small mesentery (15 cases of ileum and 1 case of jejunum), and 1 case of ascending and transverse colon. Including 6 cases of malignant lymphoma (non-Hodgkin’s disease in 5 cases, Hodgkin’s disease in 1 case), lymphangioma, inflammatory pseudotumor in 3 cases, 2 cases of metastatic tumors, vascular endothelial cell sarcoma, leiomyosarcoma, fibroids , Simple cyst in 1 case. In addition to 2 cases of lymphoma and 1 case of metastatic tumor showed multiple mesenteric mass, some cases associated with retroperitoneal mass, the rest were isolated lumps (this is the only CT manifestations). Mass push the bowel, part of the intestine is wrapped, near the mesentery blurred. “Sandwich” sign more common in malignant lymphoma. Conclusion CT has a great diagnostic value for mesenteric masses. Combined with the anatomy of the lesions, the pathological basis and the characteristics of ultrasound, CT can be prompted to preoperative or even correct positioning and qualitative diagnosis. A small number of difficult cases of diagnosis, CT guided biopsy should be diagnosed