Pozzi Mucelli R, Shariat Razavi I
Istituto di Radiologia, Università, Trieste.
Radiol Med. 1994 Oct;88(4):465-71.
The fasciae and ligaments which are visible on CT images as extremely thin structures in normal conditions tend to appear thicker in such abnormal conditions as pelvic neoplasms and are therefore easily demonstrated on axial scans. To assess the CT patterns and the meaning of fascial thickening, the CT images of 40 patients with pelvic tumors (25 rectal, 7 uterine, 6 ovarian and 2 bladder lesions) were examined. Ten cases of peritoneal carcinomatosis with ascitis were also studied. The umbilico-prevesical fascia was demonstrated in 60% of cases, while the medial umbilical ligaments, the pelvic visceral fascia and the rectovesical and rectovaginal septa were detected in 90, 96 and 100% of cases, respectively. Fascial thickening is not a specific sign of neoplastic disease since it can be due to neoplastic infiltration or be the response to an irritative stimulus. Moreover, fascial thickening can be observed also in inflammatory conditions of the pelvis and following major traumas. Thickened fasciae and ligaments make the demonstration of paravesical, intra- and extraperitoneal spaces easier, which is useful to distinguish both etiology and site of pelvic fluid collections. All these pieces of information lead to better understanding pelvic abnormalities.
在正常情况下，筋膜和韧带在CT图像上表现为极薄的结构，而在盆腔肿瘤等异常情况下往往会显得更厚，因此在轴位扫描中很容易显示出来。为了评估筋膜增厚的CT表现及意义，对40例盆腔肿瘤患者（25例直肠癌、7例子宫癌、6例卵巢癌和2例膀胱癌）的CT图像进行了检查。还研究了10例伴有腹水的腹膜癌转移病例。脐膀胱前筋膜在60%的病例中显示，而脐内侧韧带、盆内脏筋膜以及直肠膀胱隔和直肠阴道隔分别在90%、96%和100%的病例中被检测到。筋膜增厚并非肿瘤性疾病的特异性征象，因为它可能是由于肿瘤浸润或对刺激性刺激的反应所致。此外，在盆腔炎症和重大创伤后也可观察到筋膜增厚。增厚的筋膜和韧带使膀胱旁、腹膜内和腹膜外间隙的显示更加容易，这有助于区分盆腔积液的病因和部位。所有这些信息有助于更好地理解盆腔异常情况。
