本文關(guān)鍵詞： 腹直肌病變 轉(zhuǎn)移瘤 膿腫 體層攝影術(shù) X線計算機　出處：《放射學實踐》2016年08期 　論文類型：期刊論文

【摘要】：目的:分析腹直肌腫塊的CT表現(xiàn),探討CT診斷思路和要點。方法:對55例經(jīng)病理證實的腹直肌腫塊的CT表現(xiàn)進行回顧性分析。全部病例均行64層螺旋CT平掃及增強掃描,由2位放射科醫(yī)師結(jié)合癥狀和病史,共同分析腫塊的CT影像特征。結(jié)果:1韌帶樣瘤13例:以青年女性多見(11/13),7例有剖宮產(chǎn)史,4例為腫瘤術(shù)后復發(fā)。大部分病灶(10/13)呈梭形與腹直肌長軸平行,平掃呈等或稍低密度,增強呈明顯強化。2血管瘤2例:病灶密度不勻,增強呈延遲強化,可見鈣化及血管影各1例。3子宮內(nèi)膜異位7例:均有剖宮產(chǎn)史。病灶為實性4例,囊實性3例,其中1例可見病灶內(nèi)出血;增強后腫塊實性部分強化較明顯。4局灶性肌炎1例。病灶邊界不清,密度不均,增強呈不規(guī)則強化。5膿腫9例:7例為非特異性膿腫(其中3例為切口感染),2例為特異性膿腫(結(jié)核性膿腫)。平掃顯示病灶邊界不清,有中心壞死區(qū)和/或氣體影,增強后呈環(huán)形或不規(guī)則強化。6血腫3例:均有腹部創(chuàng)傷史。病灶呈梭形,邊界光整,平掃呈高密度1例、等低混雜密度2例,增強后無強化,1例邊緣見新生血管影。7轉(zhuǎn)移瘤20例:均有惡性腫瘤病史。16例手術(shù)后患者中合并多處轉(zhuǎn)移12例,其中4例為腹直肌切口轉(zhuǎn)移;4例未行手術(shù)者除腹直肌轉(zhuǎn)移外合并多處轉(zhuǎn)移。病灶密度欠均勻、可見不規(guī)則壞死灶18例,增強掃描呈環(huán)形強化。結(jié)論:腹直肌腫塊的類型多樣,結(jié)合臨床癥狀及病史,并對CT表現(xiàn)進行細致觀察和分析,能較準確地進行定性診斷。
[Abstract]:Objective: to analyze the CT findings of rectus abdominis mass, and to discuss the main points of CT diagnosis. Methods: the CT findings of 55 cases with pathologically proved rectus abdominis mass were retrospectively analyzed. All cases were performed 64-slice spiral CT plain scan and enhanced CT scan. Combined with symptoms and medical history by two radiologists, Results among the 13 cases of ligamentoid tumor of 1: 11 / 13, 7 cases had history of cesarean section and 4 cases had recurrence after operation. Most of the lesions presented spindle shape parallel to rectus abdominis longaxis, plain scan showed isosensity or slightly lower density, most of the lesions were parallel to the long axis of rectus abdominis. 2 hemangioma showed obvious enhancement in 2 cases: the density of the lesion was uneven, the enhancement was delayed enhancement, calcification and vascular shadow were seen in 1 case and 3 cases in each case, 7 cases had a history of cesarean section, the focus was solid in 4 cases, cystic solid in 3 cases. One case had intracerebral hemorrhage, one case had focal myositis with solid partial enhancement of mass after enhancement, the boundary of the lesion was not clear, and the density was uneven. Enhancement showed irregular enhancement of 5 abscesses in 9 cases (7 cases of non-specific abscess) (3 cases of incision infection and 2 cases of specific abscess (tuberculous abscess). Plain scan showed unclear boundary of lesion with central necrotic area and / or gas shadow. There were 3 cases of hematomas with circular or irregular enhancement after enhancement: all had a history of abdominal trauma. The lesions were fusiform, borderline smooth, high density on plain scan in 1 case, and equal low mixed density in 2 cases. There were 20 cases of neovascularization metastases in 1 case without enhancement after enhancement: 12 cases were complicated with multiple metastases in 16 cases with history of malignant tumor after operation, 12 cases were complicated with multiple metastases, 12 cases were complicated with multiple metastases, 12 cases were complicated with multiple metastasis. In 4 cases of rectus abdominis incision metastasis, 4 cases without operation were accompanied with multiple metastases except rectus abdominis. The density of lesions was uneven, and irregular necrotic foci were found in 18 cases. Conclusion: the types of rectus abdominis masses are various. Combined with clinical symptoms and medical history and careful observation and analysis of CT findings, qualitative diagnosis can be made more accurately.
【作者單位】： 廣東省開平市中心醫(yī)院放射科;中山大學附屬第一醫(yī)院醫(yī)學影像科;廣東省佛山市南海區(qū)人民醫(yī)院放射科;
【分類號】：R445.2;R735

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