Horton Karen M, Lawler Leo P, Fishman Elliot K
Department of Radiology, Johns Hopkins Medical Institutions, 601 N Caroline St, Rm 3251, Baltimore, MD 21287, USA.
Radiographics. 2003 Nov-Dec;23(6):1561-7. doi: 10.1148/rg.1103035010.
Sclerosing mesenteritis is a complex inflammatory disorder of the mesentery. Although sclerosing mesenteritis is often associated with other idiopathic inflammatory disorders such as retroperitoneal fibrosis, sclerosing cholangitis, Riedel thyroiditis, and orbital pseudotumor, its exact cause is unknown. The computed tomographic (CT) appearance of sclerosing mesenteritis will vary depending on the predominant tissue component (fat, inflammation, or fibrosis). CT plays an important role in suggesting the diagnosis in the proper clinical setting and can be useful in distinguishing sclerosing mesenteritis from other mesenteric diseases with similar CT features such as carcinomatosis, carcinoid tumor, lymphoma, desmoid tumor, and mesenteric edema. Nevertheless, surgical biopsy and pathologic analysis are usually necessary to make the diagnosis. Treatment may consist of therapy with steroids, colchicine, immunosuppressive agents, or orally administered progesterone. Surgical resection is sometimes attempted for definitive therapy, although the surgical approach is often limited by vascular involvement. CT with three-dimensional volume rendering is optimal for accurate, noninvasive follow-up of sclerosing mesenteritis and of any potential complications.
硬化性肠系膜膜炎是一种复杂的肠系膜炎症性疾病。尽管硬化性肠系膜膜炎常与其他特发性炎症性疾病相关，如腹膜后纤维化、硬化性胆管炎、Riedel甲状腺炎和眼眶假瘤，但其确切病因尚不清楚。硬化性肠系膜膜炎的计算机断层扫描（CT）表现会因主要组织成分（脂肪、炎症或纤维化）的不同而有所差异。CT在适当的临床环境中对提示诊断起着重要作用，并且有助于将硬化性肠系膜膜炎与其他具有相似CT特征的肠系膜疾病区分开来，如癌性腹膜炎、类癌肿瘤、淋巴瘤、硬纤维瘤和肠系膜水肿。然而，通常需要手术活检和病理分析才能做出诊断。治疗可能包括使用类固醇、秋水仙碱、免疫抑制剂或口服孕激素进行治疗。有时会尝试手术切除以进行确定性治疗，尽管手术方法常常受到血管受累情况的限制。采用三维容积再现技术的CT对于准确、无创地随访硬化性肠系膜膜炎及其任何潜在并发症最为理想。
