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目的探讨MSCT淋巴管成像在原发性小肠淋巴管扩张症(PIL)中的诊断价值。方法回顾性分析经手术病理证实的16例PIL患者的影像学资料,所有患者均于直接淋巴管造影术后行胸腹部MSCT联合扫描,并行内镜检查,将MSCT图像和手术病理及内镜结果进行对照。结果 16例患者MSCT淋巴管成像均能清晰显示病变肠管及肠管以外病变,肠管扩张14例,肠壁增厚13例,胸腔积液5例,腹腔积液7例,心包积液3例,肠系膜水肿12例,肠系膜结节6例,腹腔淋巴管瘤2例;肠淋巴干反流7例,腰淋巴干反流13例,胸膜及肺内淋巴反流3例,心包纵隔淋巴反流3例,纵隔肺淋巴反流4例,T8以下水平胸导管梗阻1例,胸导管出口梗阻14例。结论 MSCT淋巴管成像可以清晰显示PIL肠管本身及肠管以外病变的部位、范围及程度,为临床诊断和治疗提供重要依据。
Objective To investigate the diagnostic value of MSCT lymphatic imaging in primary intestinal lymphatic distension (PIL). Methods The imaging data of 16 cases of PIL confirmed by surgery and pathology were retrospectively analyzed. All the patients underwent thoracoabdominal and MSCT combined with direct lymphangiography, and the results of MSCT and pathology and endoscopy For comparison. Results 16 cases of MSCT lymphatic imaging can clearly show lesions outside the bowel and other lesions, intestinal dilatation in 14 cases, 13 cases of intestinal wall thickening, pleural effusion in 5 cases, 7 cases of peritoneal effusion, pericardial effusion in 3 cases, mesenteric 12 cases of edema, 6 cases of mesenteric nodules, 2 cases of intra-abdominal lymphangioma, 7 cases of intestinal lymph node reflux, 13 cases of lumbar lymph node reflux, 3 cases of pleural and pulmonary lymphatic reflux, 3 cases of pericardial mediastinal lymphatic flow 4 cases of mediastinal pulmonary lymphatic reflux, 1 case of thoracic duct obstruction below T8, and 14 cases of thoracic duct obstruction. Conclusion MSCT lymphatic imaging can clearly show the location, extent and extent of the pathological changes outside the intestine and the intestinal tract of PIL, and provide an important basis for clinical diagnosis and treatment.