摘要
目的探讨腰疝的CT影像学表现对临床诊治的价值。方法对6年间25例腰疝患者27个疝囊的诊断、治疗及CT影像学表现等进行回顾性总结和分析。结果腰上三角疝23个,腰下三角疝2个,腰上下三角疝均累及2个。疝环直径大小约1.4～13.7cm,其中4cm以下18个,4～6cm 6个,疝环大于7cm 3个;疝囊2.0cm×1.3cm～11.5cm×5.9cm,其疝出内容物的大小与疝环不成比例;疝出内容物:3例结肠,1例结肠和回肠,合并小肠梗阻,其余均为脂肪组织及系膜。18例上界为12肋下缘,7例为11肋下缘,疝环越大者周围肌群均较薄弱。5例手术,随访未见复发。结论 CT能明确疝环的大小,周围腹壁肌群薄弱程度,与骨组织的关系,还能提示疝内容物的性质和进一步排除其它性质的病变,依据影像学表现指导临床选择合适的手术方式。
Objective To investigate value of CT imaging in the diagnosis and treatmen of lumbar hernia. Methods We retrospectively analyzed the data, in terms of diagnosis, treatment and CT imaging, of 25 patients with lumbar hernia who were referred to medical care in six years. Results There were 23 cases of superior lumbar hernias, 2 cases of inferior lumbar hernias, 2 cases involving superior and inferior lumbar hernias. Hernia ring in diameter ranged from 1.4 to 3.7 cm, in which 18 cases were less than 4 cm, 6 cases ranged from 4 to 6 cm, 3 cases with the hernia ring were more than 7 cm. Sac size ranged from 2.0 cm）〈 1.3 cm to 11.5 cmX 5.9 cm and the size of the hernia contents was out of proportion with the hernia ring. Hernia contents included colon in 3 cases, colon and ileum （superior and inferior lumbar hernia） with small bowel obstruction in 1 case, and adipose tissue and mesentery in the rest. Compared with weak rib margin, 18 cases were located in the upper bound of th12 rib, 7 cases in the llth rib＇s edge. The greater hernia ring size, the weaker sur- rounding muscles. 5 cases received operations and no recurrence was found during follow-up. Conclusion CT can clearly show hernia, measure the size of ring, the weak degree of surrounded abdominal wall muscles and bones, the nature of the hernia contents, and further exclude the other disease. Based on the imaging findings, the appropriate surgical approach can be selected.
出处
《医学影像学杂志》
2013年第2期265-267,共3页
Journal of Medical Imaging
关键词
腰疝
诊断
手术
体层摄影术
X线计算机
Lumbar hernia
Diagnosis
Surgery
Tomography, X-ray computed
