Jin Hang, Min Peng-qiu, Yang Zhi-gang, Song Bin, Wu Bing
Department of Radiology, West China Hospital, Sichuan University, Guo Xue Xiang, Chengdu, Sichuan 610041, China.
Surg Radiol Anat. 2008 Feb;30(1):69-75. doi: 10.1007/s00276-007-0283-4. Epub 2007 Dec 4.
In view of the descriptions of the CT manifestations on the greater omentum (GO) were not precise and detailed enough in the previous literature, we tried to evaluate the radiologic-anatomical features of the GO and to address the related clinical implications for the radiologic diagnosis and surgical application.
We evaluated the GO by using multi-detector row CT (MDCT) scanning in 50 individuals correlating with anatomical basis and clinical application. Emphasis was placed on the following items: the anatomical distribution and location of the GO; the CT manifestations of the vasculature, fatty tissue and lymph nodes.
The gastro-epiploic vessel, the landmark for delineating the GO, was visualized in 50/50 cases (100%). The gastro-colic vein was detected in 34/50 cases (68%). The free-hanging portion, 48 cases revealed, seemed to have the capability of 'migration': it is located in the subphrenic spaces in 9/48 cases (19%) and distributed in the right lower quadrant predominantly in 10/48 cases (21%). Three-dimensional reformatted images, obtained in five cases, demonstrated the return of the gastro-epiploic vein distinctly. Lymph nodes were rarely detected within the GO.
The depicted omental vessels, visualized by using multi-planar reconstruction images together with three-dimensional reformatted images, played a crucial role in delineating the GO comprehensively. It can provide the valuable data for the radiologic diagnosis and surgical therapy planning including surgery of reconstruction, pancreas, portal hypertension as well as infections and neoplastic diseases.
鉴于既往文献中对大网膜(GO)CT表现的描述不够精确和详细,我们试图评估GO的放射解剖学特征,并探讨其在放射诊断和手术应用方面的相关临床意义。
我们对50例个体使用多排螺旋CT(MDCT)扫描评估GO,并与解剖学基础及临床应用相关联。重点关注以下项目:GO的解剖分布和位置;血管、脂肪组织及淋巴结的CT表现。
界定GO的标志性结构胃网膜血管在50例(100%)中均清晰显示。胃结肠静脉在34/50例(68%)中被检测到。48例显示的游离下垂部分似乎具有“移动”能力:9/48例(19%)位于膈下间隙,10/48例(21%)主要分布于右下腹。5例获得的三维重建图像清晰显示了胃网膜静脉的走行。GO内很少检测到淋巴结。
利用多平面重建图像及三维重建图像显示的网膜血管在全面界定GO方面发挥了关键作用。它可为放射诊断及手术治疗规划提供有价值的数据,包括重建手术、胰腺手术、门静脉高压手术以及感染和肿瘤疾病的手术。