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目的:分析腹腔内疝的多排螺旋CT(Multi-detector row spiral CT,MDCT)影像学表现,探讨MDCT对诊断腹腔内疝的价值。方法:收集2007-2015年间我科术前行MDCT检查且经手术证实的腹腔内疝病人8例(左侧十二指肠旁疝2例,经肠系膜疝5例,子宫阔韧带疝1例)。分析腹腔腹腔内疝的MDCT表现和特征。结果:左侧十二指肠旁疝主要表现为呈包块样聚集的肠袢位于胃胰之间,屈氏韧带的左方,推压胃后壁前移。经肠系膜疝表现为聚集的小肠袢紧贴腹前壁,和腹壁之间无大网膜覆盖。子宫阔韧带疝表现为子宫侧旁聚集的扩张小肠袢,其积液扩张及近侧小肠梗阻表现。疝的共同MDCT征象包括:肿块状或者簇状异聚集的小肠袢;周围脏器或肠管的移位;肠梗阻的征象;肠系膜血管的改变(牵拉,移位,扭曲及充血等)。结论:腹腔内疝的MDCT表现具有一定的特征性,对于术前准确诊断有较高的价值。
Objective: To analyze the imaging findings of intra-abdominal hernia by multi-detector row spiral CT (MDCT) and investigate the value of MDCT in the diagnosis of intra-abdominal hernia. Methods: Eight cases of intraperitoneal hernia who had MDCT examination confirmed by surgery during 2007-2015 (2 cases of left duodenal hernia, 5 cases of mesenteric hernia and 1 case of broad ligament hernia) . Analysis of abdominal intra-abdominal hernia MDCT performance and characteristics. Results: The left side of the duodenal hernia mainly presents as agglomerate-like intestinal gut located between the stomach and the pancreas, the left side of the ligaments, pushing the posterior wall of the stomach forward. The mesenteric herniation showed aggregation of the small intestine 袢 close to the anterior abdominal wall, and no omental coverage between the abdominal wall. The uterine broad ligament hernia showed the side of the uterus gathered dilated intestinal loop, its effusion expansion and proximal small bowel obstruction performance. The common MDCT signs of hernias include: intestinal metaplasia of masses or clusters; dislocation of surrounding organs or intestine; signs of intestinal obstruction; changes in mesenteric vessels (traction, displacement, distortion, congestion, etc.). Conclusion: The intra-abdominal hernia MDCT performance has some characteristics, for the accurate diagnosis of preoperative value has a higher value.