首都医科大学学报 ›› 2007, Vol. 28 ›› Issue (6): 743-747.

• 专题报道 • 上一篇    下一篇

多层螺旋CT在急性缺血性肠病诊断中的价值

陈明, 李选   

  1. 北京大学第三医院放射科
  • 收稿日期:2007-10-16 修回日期:1900-01-01 出版日期:2007-12-24 发布日期:2007-12-24
  • 通讯作者: 李选

The Clinical Value of Multi-slice Helical CT in the Diagnosis of Acute Intestinal Ischemia

Chen Ming, Li Xuan   

  1. Department of Radiology, The Third Hospital of Peking University
  • Received:2007-10-16 Revised:1900-01-01 Online:2007-12-24 Published:2007-12-24

摘要:

目的 探讨多层螺旋CT(MSCT)诊断急性肠缺血的临床应用价值。方法 回顾性分析24例经临床证实的急性肠缺血患者的CT表现。所有患者均行CT检查,包括平扫、动脉期、门脉期扫描及血管重建,2例行MSCT灌注扫描;21例行DSA检查及介入治疗;3例行肠切除手术。结果 应用MSCT血管重建技术诊断肠系膜上静脉血栓形成13例、肠系膜上动脉栓塞5例、肠系膜上动脉狭窄5例、腹腔干狭窄1例。不同病因和不同程度的肠缺血CT间接征象有一定差异:肠系膜静脉血栓形成时,肠壁增厚、肠系膜水肿、腹水多见;肠壁积气仅见于全层坏死,而其他征象均可见于不同病因、不同程度的肠缺血。结论 MSCT能准确诊断肠缺血并明确病因,有助于判断缺血程度。

关键词: 肠缺血, 体层摄影术, X线计算机

Abstract:

Objective To retrospectively explore the clinical value of multi-slice helical CT(MSCT) in the diagnosis of acute intestinal ischemia.Methods MSCT(plain scan,arterial and portal vein phase scan,and then vessel reconstruction) was performed in 24 patients with acute intestinal ischemia.Of the 24 patients,21 underwent digital subtraction angiography and interventional treatment procedure,and the 3 others were treated with enterotomy.Results The causes of acute intestinal ischemia in the 24 patients were accurately revealed on MSCT as superior mesenteric vein thrombosis(n=13),superior mesenteric artery embolism(n=5),superior mesenteric artery stenosis(n=5) and celiac trunk stenosis(n=1).The indirect CT findings included luminal dilatation,wall thickening or thinning,wall pneumatosis,mesenteric edema,abnormal density,reduction or absence of wall enhancement.The bowel wall thickening,mesenteric edema and ascites were observed in most patients with superior mesenteric vein thrombosis,and the wall pneumatosis was only seen in patients with transmural infarction.Conclusion The integrative MSCT examination has great value in the diagnosis of the acute intestinal ischemia,which can identify the causes,and estimate the ischemic degree.

Key words: intestinal ischemia, tomography, X-ray computer

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