儿童腹部脏器外囊性病变的的CT诊断

摘要

Objective; To study the CT diagnosis and differential diagnosis of abdominal cystic lesions in children. Methods: The CT features of 35 cases of pathologically proved abdominal cystic lesions not in the parenchymal organs was studied retrospectively. Results:There were 11 cases of lymphangioma (7 cases of mesenteric lymphangioma and 4 cases of retroperitoneal lymphangioma) ,they appeared as cystic lesions with irregular shape,well defined margin,thin wall and lowrntension;there were linear septations in 8 cases,and after contrast administration no enhancement was observed.The features rntension ; there were linear septations in 8 cases, and after contrast administration no ennancement was ODserved. The features of congenital mesenterial cysts (n=8) were:round or oval,well defined,with thin and even wall; two of the 8 cases were multilocular; after contrast administration there was enhancement of cystic wall in 2 cases and no enhancement in 6. The di ameters of all four greater omentum cysts were more than 6cm, located in front of the abdominal cavity with irregular shape. In six cases of intestinal duplication there was close relationship with the intestinal loops,from which 4 cases had tu bular form and two cases had oval form,enhancement of cystic wall was observed in 4 cases. Three of four cases of cystic teratoma located at retroperitoneal space and one at sacroccygeal region,linear calcificaation could be seen in two cases. In four cases of abdominal abscess,there were irregular liquid density areas with thick and uneven wall,with marked enhance ment of the wall after contrast administration. Conclusion: For most abdominal cystic lesions, CT can display the morpholog ic features,size,loction and relationship with adjacent structures,and thus accurate diagnosis can be obtained.%目的:探讨CT对儿童腹部脏器外囊性病变的诊断价值.方法:回顾性分析35例经手术病理证实的儿童腹部脏器外囊性病变的CT表现.结果:淋巴管瘤11例,其中肠系膜淋巴管瘤7例,腹膜后淋巴管瘤4例,肿块形态不规则,囊壁菲薄,张力低,边缘清楚,其中8例可见线条状分隔,8例行增强扫描均未见强化.肠系膜囊肿8例,均为先天性肠系膜囊肿,形态较规则,边缘清晰锐利,囊壁薄而均匀,6例为单房,2例为多房,2例囊壁呈线状强化,6例囊壁无强化.大网膜囊肿4例,长径均大于6cm,病灶位于腹腔前方,紧贴前腹壁,形态不规则.肠重复畸形6例,均与肠管关系密切,4例呈管状,2例呈类圆形,4例囊壁可见强化.囊性畸胎瘤4例,3例位于腹膜后,1例位于骶尾部,2例囊壁可见线条状钙化.腹部脓肿2例,呈不规则液性密度区,囊壁较厚且厚薄不均,增强时明显强化.结论:CT对腹部脏器外囊性病变的形态特征、大小范围及与周围组织结构的关系显示清晰,能对大多数病变作出准确诊断.