• 四川大學華西醫(yī)院放射科(成都610041);;
  • #博士生,現(xiàn)在云南省第一人民醫(yī)院放射科工作(昆明650021);

目的研究胃裸區(qū)(包括其后方、胃膈韌帶內脂肪)局部無病理改變情況下的CT表現(xiàn)特征。方法選擇上腹腔積液但病變未累及胃裸區(qū)的病例共30例,觀察無病理改變的胃裸區(qū)顯示率、CT表現(xiàn)特征; 同時對炎癥、腫瘤侵犯胃裸區(qū)的病例,觀察病理情況下胃裸區(qū)的CT表現(xiàn)。全部病例均采用螺旋CT增強掃描。結果上腹腔積液患者30例,CT掃描均顯示胃裸區(qū)的存在,其顯示率為100%。于胃食管連接平面開始出現(xiàn)胃裸區(qū),肝十二指腸韌帶、網膜孔平面胃裸區(qū)完全消失,即胃裸區(qū)終止于該平面上方; 門靜脈左支矢狀部平面胃裸區(qū)范圍最大,在該平面胃裸區(qū)左右間距(即胃膈韌帶左右層間距)平均值為(4.39±0.08)cm (3.8~5.7 cm)。急性胰腺炎侵犯胃裸區(qū)主要表現(xiàn)為胃裸區(qū)腫脹、增寬; 平滑肌肉瘤侵犯胃裸區(qū),腫塊與膈肌腳分界不清; 淋巴瘤、轉移性腫瘤侵犯胃裸區(qū)表現(xiàn)為胃裸區(qū)增厚、其內見小結節(jié)狀或腫大融合的淋巴結。結論采用螺旋CT增強掃描有助于詳細觀察胃裸區(qū)的變化,有利于腹膜后間隙疾病的全面、準確診斷,并有助于制訂詳細的手術方案。

引用本文: 李鵬,陳衛(wèi)霞,閔鵬秋. 胃裸區(qū)CT表現(xiàn)及其臨床應用. 中國普外基礎與臨床雜志, 2003, 10(3): 284-287. doi: 復制

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  2. 2. 王永貴主編.解剖學 [M]. 北京:人民衛(wèi)生出版社,1997∶215~219.
  3. 3. Bannister LH,Berry MM, Collins P. Gray’s anatomy [M]. 38ed. London: Longman Group Ltd. 1995∶ 1754-1755.
  4. 4. Wald H, Polk HC Jr. Anatomical variations in hiatal and upper gastric areas and their relationship to difficulties experienced in operations for reflux esophagitis [J]. Ann Surg, 1983; 197(4)∶389.
  5. 5. 羅兆明,黃鴻鈞. 胃上部及其周圍結構的初步觀察 [J]. 廣州醫(yī)學院學報,1985; 4(1)∶5.
  6. 6. 丁國芳,王海斌. 胃裸區(qū)的形態(tài)觀察及其臨床意義 [J]. 中國解剖學雜志,1991; 9(1)∶26.
  7. 7. 劉樹偉,劉漢民. 膈下間隙的橫斷面解剖研究 [J]. 中華臨床外科雜志,1996; 34(2)∶120.
  8. 8. Balthazar EJ. CT diagnosis and staging of acute pancreatitis [J]. Radiol Clin North Am,1989; 27(1)∶19.
  9. 9. Korobkin M, Silverman PM, Quint LE, et al. CT of the extraperitoneal space: normal anatomy and fluid collections[J]. AJR Am J Roentgenol,1992; 159(5)∶933.
  10. 10. Meyers MA. Dynamic radiology of the abdomen: normal and pathological anatomy [M]. 2ed. New York: SpringerVerlag, 1976∶113-194.
  11. 11. Lim JH, Yoon Y, Lee SW, et al. Superior aspect of the perirenal space: anatomy and pathological correlation [J]. Clin Radiol, 1988; 39(4)∶368.