刘宏,王海宝,余长亮.腹部CT和MRI诊断腰疝[J].中国医学影像技术,2021,37(7):1025~1028
腹部CT和MRI诊断腰疝
Abdominal CT and MRI in diagnosis of lumbar hernia
投稿时间:2020-05-12  修订日期:2021-03-05
DOI:10.13929/j.issn.1003-3289.2021.07.014
中文关键词:  疝,腹  体层摄影术,X线计算机  磁共振成像  腰疝
英文关键词:hernia, abdominal  tomography, X-ray computed  magnetic resonance imaging  lumbar hernias
基金项目:
作者单位E-mail
刘宏 安徽医科大学第一附属医院放射科, 安徽 合肥 230022  
王海宝 安徽医科大学第一附属医院放射科, 安徽 合肥 230022  
余长亮 安徽医科大学第一附属医院放射科, 安徽 合肥 230022 1375616069@qq.com 
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中文摘要:
      目的 分析腹部CT和MRI诊断腰疝的价值。方法 回顾性分析75例临床诊断腰疝患者,观察其CT及MRI表现。75例均接受CT平扫,其中65例接受CT增强检查,20例接受MRI平扫及增强检查。结果 75例中,CT共检出79处腰疝,MRI共检出21处腰疝(其中1例为双侧病变),均表现为经腹后外侧壁缺损突出至腰背部的软组织肿块,邻近肌肉受压变薄/萎缩,其中75处(75/79,94.94%)为腰上三角疝,3处(3/79,3.80%)为腰下三角疝,1处(1/79,1.27%)为弥漫性腰疝。75例中,39例(39/75,52.00%)为右侧腰疝,32例(32/75,42.67%)为左侧、4例(4/75,5.33%)为双侧腰疝。疝囊平均最大径(3.83±1.82)cm;59个疝囊呈烧瓶样或椭圆形,20个类圆形或扁丘状;疝环平均最大径(2.13±1.22)cm;疝囊密度或信号因疝内容物不同而有所不同,66处(66/79,83.54%)疝内容物为脂肪组织,10处(10/79,12.66%)为结肠,2处(2/79,2.53%)为多脏器疝出,1处(1/79,1.27%)为肝脏。MRI均清楚显示病变处深筋膜缺损及肌层,而CT显示疝囊及疝环、观察相邻骨骼更佳。结论 腰疝CT及MRI表现具有一定特征性,二者相结合有利于提高术前诊断准确率。
英文摘要:
      Objective To analyze the value of abdominal CT and MRI in diagnosis of lumbar hernia (LH). Methods Data of 75 patients with clinically diagnosed LH were retrospectively analyzed, and CT and MRI manifestations of LH were observed. All patients underwent plain CT scanning, 65 underwent enhanced CT scanning, while 20 patients underwent plain and enhanced MRI. Results Among 75 patients, 79 LH were detected with CT, 21 LH were detected with MRI (1 case with bilateral lesions), present as soft tissue masses protruding to the lower back through transabdominal lateral wall defects, accompanied by thinning/atrophy of the adjacent muscles. Among 79 LH lesions, 75 (75/79, 94.94%) were superior LH, 3 (3/79, 3.80%) were inferior LH and 1 (1/79, 1.27%) was diffuse LH, occurred on the right sight in 39 cases (39/75, 52.00%), on the left side in 32 cases (32/75, 42.67%), while bilateral LH were found in 4 cases (4/75, 5.33%). The average maximum diameter of hernia sac was (3.83±1.82)cm. Fifty-nine hernia sacs were flask-like or oval, 20 were round or flat-hump-like. The average diameter of hernia ring was (2.13±1.22)cm. The densities or signals varied with the hernia contents,which contained adipose tissue in 66 (66/79, 83.54%), part of colon in 10 (10/79, 12.66%), of multiple organs in 2 (2/79, 2.53%) and of liver in 1 (1/79, 1.27%) hernia sac. MRI demonstrated deep fascial defect and muscular layer on the positions of lesions more clearly than CT, while CT depicted hernia sacs, hernia rings and the adjacent bone structures better than MRI. Conclusion CT and MRI manifestations of LH had certain characteristics. Combination of CT and MRI helped to improve the accuracy of preoperative diagnosis of LH.
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