Department of Diagnostic Radiology, Dong-A University College of Medicine, Seo-Ku, Busan, Republic of Korea.
Clin Radiol. 2011 Oct;66(10):966-73. doi: 10.1016/j.crad.2011.05.006.
To investigate the computed tomography (CT) imaging features of omental infarction in patients who underwent laparoscopy-assisted gastrectomy (LAG) for gastric cancer.
A retrospective study was performed on 390 patients who underwent LAG for gastric cancer. Two radiologists evaluated the CT images for the presence of omental infarction. The CT pattern was characterized at initial presentation and the evolutional changes were evaluated. The initial CT appearance of omental infarctions were categorized into the following four types: type 1 (ill-defined, heterogeneous, fat density lesion); type 2 (well-defined fat density lesion with rim enhancement); type 3 (well-defined heterogeneous lesion with fat component); and type 4 (well-defined heterogeneous lesion without a fat component).
Of the 390 patients involved, nine patients (2.3%; six male and three female with a mean age of 57 years) were diagnosed with omental infarction. Infarctions averaged 4.1 cm (range 2-7.3 cm) in diameter. Among nine patients with omental infarction, two patients had type 1 lesions, two had type 2, two had type 3, and three type 4. All infarctions became smaller and better defined with evolution. In two patients who presented with type 1 lesions on initial CT, each lesion was progressed to type 2 and type 3 on follow-up CT. In two patients with type 3 lesions on initial CT, the lesions changed to type 4 on follow-up CT.
An awareness of the various CT features and evolutional changes in omental infarction after LAG for gastric cancer can help ensure the correct diagnosis and to avoid misdiagnosis for omental implants.
探讨腹腔镜辅助胃癌根治术后网膜梗死的 CT 影像学特征。
对 390 例行腹腔镜辅助胃癌根治术的患者进行回顾性研究。两位放射科医生评估了 CT 图像中网膜梗死的存在情况。对初始 CT 表现和演变过程中的 CT 模式进行了特征描述。将网膜梗死的初始 CT 表现分为以下四种类型：1 型（边界不清、不均匀、脂肪密度病变）；2 型（边界清楚的脂肪密度病变伴边缘强化）；3 型（边界清楚的混杂性病变伴脂肪成分）；4 型（边界清楚的混杂性病变无脂肪成分）。
在 390 例患者中，有 9 例（2.3%；6 例男性，3 例女性，平均年龄 57 岁）被诊断为网膜梗死。梗死灶平均直径为 4.1cm（范围 2-7.3cm）。在 9 例网膜梗死患者中，2 例为 1 型病变，2 例为 2 型，2 例为 3 型，3 例为 4 型。所有梗死灶在随访中逐渐变小，边界更清晰。在 2 例初始 CT 表现为 1 型病变的患者中，每个病变在随访 CT 上均进展为 2 型和 3 型。在 2 例初始 CT 表现为 3 型病变的患者中，病变在随访 CT 上转变为 4 型。
对腹腔镜辅助胃癌根治术后网膜梗死的各种 CT 特征和演变过程有一定认识，有助于正确诊断，避免对网膜种植体的误诊。
