目的 探讨腹部非急性胰腺炎相 关性脂肪坏死病灶CT征象及其病理基础。 方法 回顾性分析我院2009年3月至2015年 3月间20例无急性胰腺炎病史，术后病理 证实为腹部脂肪坏死的住院患者的CT影像 资料，观察病灶及周围组织CT表现及强化 特征并与病理对照。结果 (1)部位：20 患者中16例发生于腹腔，4例发生于腹膜 后。(2)CT表现：分为结节型(14/20)、脂 质囊肿型(3/20)和网状疏松型(3/20)三种 类型，以结节型(14/20)最为常见，结节 型和脂质囊肿型病灶局限(最大径均值分 别为1.8cm和2.5cm)，网状疏松型病灶范 围较大(最大径均值8.5cm)。14例结节型 病灶中11例出现钙化，其中8例为环形钙 化，3例为不规则形钙化；结节型病灶血 供不丰富，仅4例轻度强化，10例未见明 显强化。脂质囊肿型病灶3例均为薄壁含 脂质囊肿(CT值<-20HU)，其中1例囊壁出 现钙化，增强后3例均出现环形强化。网 状疏松型3例均表现为混杂脂肪密度，呈 边界清晰的网格状结构，无明显钙化，增 强后轻度强化。结论 腹部非急性胰腺炎 相关性脂肪坏死CT表现具有一定特征性， 能够反映其病理特征，对病灶的正确诊治 具有重要意义。

Objective To improve diagnostic accuracy of abdomen fat necrosis correlated with non-acute pancreatitis by studying its CT feature and pathological basis. Methods 20 in-patients of Nanjing Drum Tower Hospital with non-acute pancreatitis but pathological identified with abdomen fat necrosis were enrolled in a retrospective study from 2009 March to 2015 March.CT scan and contrast enhancement scan features of the lesions and their surroundings were compared with pathological results. Results 1.Disease region: 16 patients were in abdomen while 4 were in retroperitoneal. 2.CT feature: CT features were divided into three types, nodular type(14/20),lipid cyst type(3/20),mesh loose type(3/20).The nodular type and lipid cyst type had a limited scope, with maximum mean diameter 1.8cm and 2.5cm each. The mesh loose type had a dispersed range, with maximum mean diameter 8.5cm.Calcification was found in 11/14 nodular type patients. Annular calcification was found in 8 while irregular calcification in 3.The nodular type lesions were found with deficient blood supply.4 nodular type lesions with mild contrast enhancement were found while 10 with no contrast enhancement. The lipid cyst type lesions were with low CT value (< -20HU), 1 calcification in 3 patients, all annular enhancement after contrast injection in 3 patients. The mesh loose type lesions were with hybrid fat density, clear boundary grid structure, mild contrast enhancement. Conclusion CT features of abdomen fat necrosis correlated with non-acute pancreatitis were characteristic. They have great influence on improving diagnostic accuracy.