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目的 分析 42例成人Bochdalek疝的CT表现 ,以提高对本病的认识。方法 42例均系在胸、腹部常规CT扫描中发现膈肌后上方有致密块影 ,后膈有局部缺损 ,膈上、下致密影通过膈肌缺损相连而诊断。其中男 2 5例 ,女 17例 ,平均年龄 6 4岁 ,71 4%≥ 6 0岁。结果 42例中共有 5 3个Bochdalek疝 ,其中 11例为双侧 ,左侧 2 1例 ,右侧 10例。膈肌缺损最大横径自 0 5～ 6 7cm ,中位数 2 8cm。疝的最大横径自 1 5～ 9 0cm ,中位数 3 7cm ,与膈肌缺损大小密切相关 (rs=0 72 ,P <0 0 1)。91%病例的CT上均可见有慢性肺部疾病。结论 成人Bochdalek疝不少见 ,CT能准确判断膈肌缺损的位置、疝的大小及其内容物。年龄及慢性肺部疾病对本病的形成有重要作用。
Objective To analyze the CT findings of 42 adult Bochdalek hernias to improve their understanding of the disease. Methods Forty-two patients were diagnosed by CT scan of thorax and abdomen. Complicated mass was found on the top of diaphragm after diaphragmatic injury, and the posterior diaphragm had local defect. The upper and lower diaphragm were diagnosed by the connection of diaphragm defect. There were 25 males and 17 females, with an average age of 64 years and 71 4% ≥60 years. Results A total of 53 Bochdalek hernias were found in 42 cases, of which 11 were bilateral, 21 on the left and 10 on the right. The largest diameter of diaphragmatic defect from 0 5 ~ 67cm, the median 28cm. The largest diameter of hernia from 15 ~ 90cm, the median 37cm, and the size of the diaphragm defect is closely related (rs = 0 72, P <0.01). 91% of cases of CT can be seen on the chronic lung disease. Conclusion Adult Bochdalek hernia is not uncommon, CT can accurately determine the location of diaphragm defects, the size of hernia and its contents. Age and chronic lung disease play an important role in the formation of this disease.