Kopka L, Fischer U, Gross A J, Funke M, Oestmann J W, Grabbe E
Department of Radiology I, University Hospital of Goettingen, Germany.
J Comput Assist Tomogr. 1996 Nov-Dec;20(6):919-23. doi: 10.1097/00004728-199611000-00009.
Our goal was to demonstrate possible pitfalls in the CT diagnosis of retained surgical sponges (textilomas) and to evaluate the impact of gas bubbles inside a textiloma.
Thirteen patients with textilomas were investigated with CT 3 weeks to 8 years after surgery. Twelve of the 13 textilomas were removed within 3 weeks after the first CT examination. Eight samples of surgical sponges were placed in a water bath for 6 months. Serial CT was performed to document the presence and persistence of gas bubbles.
The radiopaque marker inside the textiloma was seen in nine patients but did not lead to the diagnosis in all patients. In seven patients gas bubbles were found inside the textiloma with a typical pattern. None of these patients had an abscess formation. In vitro studies demonstrated gas bubbles in all surgical sponges scanned 1 h afterward. The number of gas bubbles was not significantly reduced after 6 months.
The variable appearance of retained surgical sponges can lead to diagnostic misinterpretations. If present, typical spongiform pattern with gas bubbles is the most specific sign for the detection of textilomas but does not indicate an abscess formation.
我们的目标是证明在CT诊断手术遗留海绵（纺织瘤）时可能存在的陷阱，并评估纺织瘤内气泡的影响。
对13例患有纺织瘤的患者在术后3周至8年进行CT检查。13个纺织瘤中的12个在首次CT检查后3周内被切除。将8个手术海绵样本置于水浴中6个月。进行系列CT检查以记录气泡的存在和持续情况。
9例患者可见纺织瘤内的不透X线标记物，但并非所有患者均借此得以诊断。7例患者的纺织瘤内发现典型形态的气泡。这些患者均未形成脓肿。体外研究显示，1小时后扫描的所有手术海绵中均有气泡。6个月后气泡数量无明显减少。
手术遗留海绵的表现各异可导致诊断误解。若存在，带有气泡的典型海绵状形态是检测纺织瘤最具特异性的征象，但并不表明形成了脓肿。
