结直肠血管瘤课件.ppt

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2010-02-03结直肠血管瘤CT定位---肠壁不均匀增厚,直肠周围血管充血确定病变范围明确有无周围结构及肠系膜受侵2010-02-03结直肠血管瘤2010-02-03结直肠血管瘤2010-02-03结直肠血管瘤2010-02-03结直肠血管瘤遗传性出血性毛细血管扩张症*Photomicrographshowingthedilated,congestedsubmucosalvesselscharacteristicofthistypeofhemangioma.*便血发生是由于畸形血管壁的破坏,穿透了粘膜层;加之粪便蠕动摩擦粘膜层;很少有浆膜层破坏,因此很少伴有腹膜炎及腹腔内出血*Rectosigmoidhemangioma,plainradiograph.Frontalviewofthepelvisshowsnumerousphleboliths,someofwhichoverliethesacrumandextendoutofthepelvis(arrows).Alateralviewshowedphlebolithsinthepresacralspace.*Figure4.Sigmoidcolon,cavernoushemangioma,single-contrastbariumstudy.Thispostevacuationviewshowsextensivelobulargrape-likeclustersoftumorinvolvingthesigmoidandrectosigmoidcolon.Phlebolithswereabsentontheplainradiograph.*AxialCTscanobtainedduringvirtualcolonoscopyofair-insufflatedcolonatlevelofuppersacrumshowsmarkedthickeningofrectosigmoidwallwithintramuralphleboliths.Multiplesmallmesentericsoft-tissuemassesarealsoseen.C,AxialCTscanobtainedduringvirtualcolonoscopyofair-insufflatedcolonatleveloflowerlumbarspineshowsthickeningofascendingcolonwithfewintramuralphleboliths.Oneareaiscloselyopposedandpossiblyadherenttoanteriorabdominalwall.AsinB,innumerablesmallmesentericmassesarevisible.*Fig.2.AACTscanshowingalargemasswithphlebolithsthroughoutthepelvisandnonhomogeneousenhancementafterinjectionofcontrastmedium.BTheCTscandemonstratesinvolvementofthedomeandposteriorwallofthebladderbythetumor.***Fig2.a€”44-year-omldanwithdiffusecavernouhsemangiomofarectosigmociodlonwhopresentewdithchronicrectalbleeding.A,AxiaClTscanshowsmarketdhickeninogfrectawlallwithperirectanletworckontaininpghiebolitinhitsantenorpart(arrow).B,AxiaTli-weightedMRimageshowsmarkedthickeninogfrectawlallandperirectanletworkhypointentsoesubcutaneousfat.PhlebolithseenonCTisretrospectivelydepictedinante

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