膈肌病变的CT、MRI表现特征及其解剖、病理基础_West China Medical Journal

Authors：

邓瑜萍 ,  杨志刚

Corresponding author：

杨志刚, Email: dyp72@126.com

Keywords：

膈肌; 解剖学; 病理学; 影像学

Video：

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【摘要】 　膈肌为胸腹腔的分界，与上下方结构的空间关系复杂。发生病变时，难以准确判断病变的起源和累及范围，外科手术与介入治疗也变得更为复杂。正确认识膈肌本身及其毗邻结构病变的解剖、病理及其CT、MRI表现特点，将有助于正确诊断以膈肌为中心的胸腹交界区疾病。现就近年来膈肌病变影像学及解剖学的研究进展进行综述，为临床治疗提供影像解剖依据。

Citation： 邓瑜萍,杨志刚. 膈肌病变的CT、MRI表现特征及其解剖、病理基础. West China Medical Journal, 2010, 25(11): 2103-2106. doi: Copy

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3.	余建群, 杨志刚, 杨开清, 等. 肺韧带对下胸部疾病螺旋CT表现的影响及其解剖学基础[J]. 中华放射学杂志, 2003, 37(1): 67-69.
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15.	Iino M, Kuribayashi S, Imakita S, et al. Sensitivity and specificity of CT in the diagnosis of inflammatory abdominal aortic aneurysms[J]. J Comput Assist Tomog, 2002, 26(6): 1006-1012.
16.	李媛, 杨志刚, 闵鹏秋, 等. 恶性淋巴瘤累及腹腔、腹膜后淋巴结的多层螺旋CT强化表现特征[J]. 中国医学影像技术, 2005, 21(2): 285-288.
17.	Harman M, Arslan H, Ayakta H, et al. Post-traumatic omental herniation into pleural space: rdaiologic features[J]. Eur J Radiol, 2003, 45(3): 93-96.
18.	Larici AR, Gotway MB, Litt HI, et al. Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury[J]. Am J Roentgenol, 2002, 179(2): 451-457.
19.	Tresallet C, Menegaux F, Izzillo R, et al. Usefulness of CT Reconstructed Pictures for Diaphragmatic Rupture after Blunt Trauma[J]. J Am Coll Surg, 2004, 198(4): 666-667.
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21.	Puls R, Kreissig R, Hosten N, et al. Tumour of the diaphragm mimicking liver lesion[J]. Eur J Radiol, 2002, 41(2): 168-169.
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23.	Ng CS, Munden RF, Libshitz HI. Malignant Pleural Mesothelioma: The spectrum of manifestations on CT in 70 cases [J]. Clin Radiol, 1999, 54(7): 415-421.
24.	伍兵, 杨志刚, 闵鹏秋. 左侧肾上腺肿瘤的螺旋CT表现及其解剖病理基础[J]. 四川大学学报•医学版, 2005, 36(6): 905-907.
25.	刘树伟, 刘汉明, 栾铭箴, 等. 膈下间隙的横断面解剖研究[J]. 中华外科杂志, 1996, 34(2): 120-122.
26.	赵振美, 刘树伟, 李振平, 等. 膈下间隙的冠状断层解剖学研究[J]. 解剖学报, 2001, 32(4): 378-382.
27.	Min PQ, Yang ZG, Lei QF, et al. Peritoneal reflections of left perihepatic region: Radiologic-Anatomic study [J]. Radiology, 1992, 182(2): 553-557.
28.	Oyar O, Yesildag A, Gulsoy UK. Bilateral and symmetric diaphragmatic crus lipomas: report of a case[J]. Comput Med Imag Graphics, 2001, 26(2): 135-137.
29.	Oyar O, Kayalioglu G, Cagirici U. Diaphragmatic crus lipoma: a case report[J]. Comput Med Imag Graphics, 1998, 22(5): 421-423.
30.	Silverman PM, David Godwin J, Korobkin M, et al. Computed tomographic detection of retrocrural air[J]. Am J Roentgenol, 1982, 138(5): 825-829.

1. 　Williams PL, Bannister LH, Berry MM. Gray′s Anatomy[M]. 38th ed. Edinburgh: Churchill Livingstone, 1995.
2. 　董炘, 劳晓燕, 苏雄. 腰肋三角的应用解剖[J]. 局解手术学杂志, 1994, 3(4): 15-18.
3. 　余建群, 杨志刚, 杨开清, 等. 肺韧带对下胸部疾病螺旋CT表现的影响及其解剖学基础[J]. 中华放射学杂志, 2003, 37(1): 67-69.
4. 　Erat S, Ciris F. Diaphragmatic hernia: diagnostic approaches with review of the Literature [J]. Eur J Radiol, 2005, 54(3): 448-459.
5. 　Berland LL, Smith JK. Multidetector array CT: once again technology creates new opportunities [J]. Radiology, 1998, 209(2): 327-329.
6. 　Gierada DS, Curtin JJ, Rickson SJ, et al. Fast gradient echo magnetic resonance imaging of the normal diaphragm[J]. J Thorac maging, 1997, 12(1): 70-74.
7. 　Naidich DP, Megibow AJ, Ross CR, et al. Computed tomography of the diaphragm: normal anatomy and variants[J]. Comput Assist Tomogr, 1983, 7(4): 633-640.
8. 　Woodring JH, Bognar B. Muscular hypertrophy of the left diaphragmatic crus: an unusual cause of a paraspinal "mass" [J]. Thorac Imaging, 1998, 13(2): 144-145.
9. 　Reina A, Vidana E, Soriano P, et al. Traumatic intrapericardial diaphragmatic hernia: case report and literature review[J]. Injury, 2001, 32(2): 153-156.
10. 　Killi D, Nadir A, Dner E, et al. Transthoracic approach in surgical management of Morgagni hernia[J]. Eur J Cardiothorac Surg, 2001, 20(5): 1016-1019.
11. 　朱明生, 王华明. 胸骨旁疝误诊为脂肪瘤2例报告[J]. 实用放射学杂志, 2003, 19(4): 382-383.
12. 　Fukuda S, Okuda K, Imamura I, et al. Surgical resection combined with chemotherapy for advanced hepatocellular carcinoma with tumor thrombus: report of 19 cases[J]. Surg, 2002, 131(3): 300-310.
13. 　Sung YM, Choe YH, Park SW, et al. Retroperitioneal arteriovenous malformation extending through the inferior vena cava into the heart and causing inferior vena cava dissection[J]. Eur Radiol, 2005, 15(6): 1173-1177.
14. 　Imamoglu M, Cay A, Kosucu P, et al. Congenital paraesophageal hiatal hernia: pitfalls in the diagnosis and treatment[J]. J Pediatr Surg, 2005, 40(7): 1128-1133.
15. 　Iino M, Kuribayashi S, Imakita S, et al. Sensitivity and specificity of CT in the diagnosis of inflammatory abdominal aortic aneurysms[J]. J Comput Assist Tomog, 2002, 26(6): 1006-1012.
16. 　李媛, 杨志刚, 闵鹏秋, 等. 恶性淋巴瘤累及腹腔、腹膜后淋巴结的多层螺旋CT强化表现特征[J]. 中国医学影像技术, 2005, 21(2): 285-288.
17. 　Harman M, Arslan H, Ayakta H, et al. Post-traumatic omental herniation into pleural space: rdaiologic features[J]. Eur J Radiol, 2003, 45(3): 93-96.
18. 　Larici AR, Gotway MB, Litt HI, et al. Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury[J]. Am J Roentgenol, 2002, 179(2): 451-457.
19. 　Tresallet C, Menegaux F, Izzillo R, et al. Usefulness of CT Reconstructed Pictures for Diaphragmatic Rupture after Blunt Trauma[J]. J Am Coll Surg, 2004, 198(4): 666-667.
20. 　Shamsuzzaman SM, Hashiguchi Y. Thoracic amebiasis[J]. Clin Chest Med, 2002, 23(2): 479-492.
21. 　Puls R, Kreissig R, Hosten N, et al. Tumour of the diaphragm mimicking liver lesion[J]. Eur J Radiol, 2002, 41(2): 168-169.
22. 　Weksler B, Ginsberg RJ. Tumour of the diaphragm[J]. Chest Surg Clin N Am. 1998, 8(2): 441-447.
23. 　Ng CS, Munden RF, Libshitz HI. Malignant Pleural Mesothelioma: The spectrum of manifestations on CT in 70 cases [J]. Clin Radiol, 1999, 54(7): 415-421.
24. 　伍兵, 杨志刚, 闵鹏秋. 左侧肾上腺肿瘤的螺旋CT表现及其解剖病理基础[J]. 四川大学学报•医学版, 2005, 36(6): 905-907.
25. 　刘树伟, 刘汉明, 栾铭箴, 等. 膈下间隙的横断面解剖研究[J]. 中华外科杂志, 1996, 34(2): 120-122.
26. 　赵振美, 刘树伟, 李振平, 等. 膈下间隙的冠状断层解剖学研究[J]. 解剖学报, 2001, 32(4): 378-382.
27. 　Min PQ, Yang ZG, Lei QF, et al. Peritoneal reflections of left perihepatic region: Radiologic-Anatomic study [J]. Radiology, 1992, 182(2): 553-557.
28. 　Oyar O, Yesildag A, Gulsoy UK. Bilateral and symmetric diaphragmatic crus lipomas: report of a case[J]. Comput Med Imag Graphics, 2001, 26(2): 135-137.
29. 　Oyar O, Kayalioglu G, Cagirici U. Diaphragmatic crus lipoma: a case report[J]. Comput Med Imag Graphics, 1998, 22(5): 421-423.
30. 　Silverman PM, David Godwin J, Korobkin M, et al. Computed tomographic detection of retrocrural air[J]. Am J Roentgenol, 1982, 138(5): 825-829.

West China Medical Journal

膈肌病变的CT、MRI表现特征及其解剖、病理基础

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