探讨食管裂孔疝(EHH)的CT表现特点，为临床诊断及治疗提供理论依据。

回顾性分析青岛大学附属医院放射科2013年1月～2017年1月76例经上消化道造影或胃镜确诊的食管裂孔疝(EHH)患者的CT资料。

CT主要表现为后纵隔食管裂孔上方层面软组织团块影经食管裂孔与膈下胃腔相连续，其中61例(80.3%)显示食管裂孔增大。根据解剖特点分为滑行疝58例、食管旁疝4例、混合型疝8例、Ⅳ型疝6例。其中假肿块型(直径≥30 mm)30例(39.5%)，假结节型(直径<30 mm)46例(60.5%)。CT显示"胸腔胃粘膜征"66例(86.8%)、"束腰征"49例(64.5%)、"脂肪环绕征"41例(53.9%)、"电缆线征"16例(21.1%)，6例Ⅳ型疝均见"阳性血管征"，且假肿块型疝囊出现上述特异性征象在假肿块型疝囊里更常见。

CT检查可以清楚的显示EHH的全貌及多种特异性征象，对该疾病的诊断具有重要价值。

Discussing CT features of esophageal hiatus hernia, to provide the basis for clinical diagnosis and treatment.

The CT imaging findings of 76 cases from radiology department in the Affiliated Hospital of Qingdao University(from january 2013 to jun 2017)with upper gastro-intestinal barium examination or gastroscopy proven esophageal hiatus hernia were retrospectively analyzed.

The main manifestations of CT were soft tissue masses located at the posterior-mediastinum, upper layer of esophageal hiatus, which communicated with gastric lumen under the diaphragm via esophageal hiatus, the distance between thecrura of diaphragm was widened in 61 cases(80.3%). According to anatomical features, there were sliding hiatal hernias of 58 cases, pure paraesophageal hernias of 4 cases, mixed hernias of 9 cases and type IV hernias of 5 cases with omental hernia.Of these, there were 30 cases(39.5%)pseudotumor type(diameter≥30 mm)and 46 cases(60.5%)of pseudonodular type(diameter<30 mm). "Gastric mucosa in chest" was 66 cases(86.8%), "Corset sign" was 49 cases(64.5%), "Fat surround sign" was 41 cases(53.9%), "Cable sign" was 16 cases(21.1%)and "Positive vascular sign" in type IV hernias was 5, they were clearly demonstrated on CT images, and the pseudotumor type sac showed the above specific signs, the probability was higher than the pseudonodular type sac.

CT can clearly display hernia sac and its multiple characteristic signs of EHH, it is very helpful in the diagnosis of EHH.