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糖尿病相关少见疾病的CT诊断

作者:李海飞 孙立国 衣高峰 刘培政 王培源 李 军

所属单位:滨州医学院烟台附属医院(山东 烟台 264100)

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摘要

目的探讨糖尿病相关少见疾病 的CT表现,提高诊断准确率。资料与方法 分析临床表现为糖尿病患者,同时伴有其 他部位异常行CT检查的患者,其中恶性外 耳道炎2例,气肿性肾盂肾炎3例,气肿性 膀胱炎2例,非酮症高血糖性舞蹈症2例, 胰高血糖素瘤1例,均经临床或手术病理 证实。结果 恶性外耳道炎CT表现为外耳 道内软组织密度影充填伴骨质破坏吸收, 气肿性肾盂肾炎表现为肾轮廓增大模糊, 肾实质多发破坏,肾功能减退或丧失,以 肾内及肾周围弥漫大量气体与低密度软组 织影共存为其特点。气肿性膀胱炎表现为 膀胱壁弥漫性积气伴或不伴膀胱内气液平 面。非酮症高血糖性舞蹈症表现为一侧性 纹状体高密度影。胰高血糖素瘤表现为皮 损及胰腺富血供肿瘤。结论 糖尿病相关 少见疾病虽然发病率低,但CT表现相对特 异,结合临床表现及血糖水平,能够做出准确诊断。

Objective To discuss the CT manifestations of diabetes related rare diseases, improve the diagnosis accuracy rate. Methods Analysis of clinical manifestations of diabetic patients, while other parts with abnormal CT examination of patients, including 2 cases of malignant external otitis, 3 patients with emphysematous pyelonephritis, 2 cases of emphysematous cystitis, 2 cases of non ketotic hyperglycaemia chorea, glucagon tumor 1 cases, were treated by operation or pathology. Results Malignant external otitis CT showed soft tissue density in external auditory canal filling with destruction of bone absorption, emphysematous pyelonephritis show renal profile increases the fuzzy, renal multiple damage, loss or loss of renal function, renal and renal diffuse to the surrounding large amounts of gas and low density soft tissue shadow coexist as its characteristics. Emphysematous cystitis is bladder wall diffuse gas with or without air fluid level within the bladder. Non ketotic hyperglycaemia chorea showed unilateral striatal high density. Glucagon tumor showed lesions and pancreatic hypervascular tumor. Conclusion Diabetes related rare disease although the incidence rate is low, but CT showed relatively specific, combined with clinical manifestation and blood glucose levels, which could be diagnosed accurately.

【关键词】糖尿病;体层摄影术,X线计算机

【中图分类号】R814.42; R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.02.32

前言

随着经济的发展,人口老龄化以及生活方式的改变,糖尿病患病 率正在迅速增加。糖尿病住院患者逐年增长,入院原因由高到低分别 为血糖控制不良、微血管并发症、脑血管并发症、心血管并发症及各 种感染[1]。糖尿病相关血管疾病很多[2-3],而其相关的少见疾病报道较 少,本文收集与糖尿病相关的少见疾病10例,分析其CT表现,以提高 对其相关疾病的认识。