16层螺旋CT诊断小肠出血性疾病的价值  

Diagnostic Value of 16-slice Spiral-CT Scans for Intestinal Hemorrhage

作　　者：胡道予[1] 李震[1] 肖明[1] 张进华[1] 宋金梅[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《放射学实践》2006年第3期218-222,共5页Radiologic Practice

摘　　要：目的:评价16层螺旋CT(MSCT)对小肠出血性疾病的诊断价值。方法:采用16层螺旋CT对26例临床拟诊小肠出血患者进行扫描,其中导管法4例,周围静脉法22例。扫描前15 min均肌注盐酸山莨菪碱20 mg,检查时饮水500 ml,采用10 mm层厚平扫后进行动脉期、静脉期双期增强扫描,双期增强图像1.25 mm薄层重建,采用多层面容积重组法(MPVR)、最大密度投影(MIP)和CT血管造影(CTA)技术进行重建分析,结合1.25 mm薄层图像对小肠出血部位及病变进行分析,并与DSA和手术病理对照,评价小肠出血性疾病MSCT的诊断价值。结果:26例临床拟诊小肠出血患者,MSCT明确诊断出血部位23例,3例MSCT未发现出血灶。其中6例行DSA,5例显示出血灶,1例表现阴性。MSCT出血显示率88.5%。CT显示出血部位:十二指肠出血6例,空肠出血8例,回肠出血9例,其中血管畸形3例,憩室3例,溃疡1例,肿瘤6例,肿瘤伴肠套叠2例,炎症和损伤6例,Crohn病2例。18例经手术、病理或内镜证实。结论:16层螺旋CT双期增强扫描结合重建技术诊断小肠出血性疾病具有较高的临床价值,可为临床治疗方案的选择及手术定位提供指导。Objective：To evaluate the diagnostic value of 16-detector-row spiral computed tomography （MSCT） for intestinal hemorrhage. Methods： 26 patients with clinically suspected intestinal hemorrhage were included in our study. The patients were initially performed with plain scans and the slice thickness of 10mm was used. Dual-phase CT scan was performed and source images of a thickness of 1.25mm were used for image reconstruction. The reconstruction techniques of MPVR （Multiplanar volume reconstruction）, MIP （Maximal intensity projectiom） and CTA （CT arteriography） were used. CT findings were correlatively studied with the manifestations revealed in DSA,surgical and pathological examinations to evaluate the value of CT in the diagnosis of intestinal hemorrhage. Results： In 26 clinically suspected cases of intestinal hemorrhage,hemorrhagic lesions were confirmed in 23 cases. In these 23 cases, DSA were performed in 6 cases with a result of 5 positive and 1 negative. There were 3 cases in which no signs of hemorrhage were found by MSCT （positive detection rate of MSCT in the diagnosis of intestinal hemorrhge was 88.5 %）. Sites of hemorrhage depicted by MSCT were as follows：duodenal hemorrhage （n：12）,jejunal hemorrhage （n：8） and ileal hemorrhage （n：9）,while the pathological nature of the hemorrhagic lesions identified by MSCT was vascular malformation for 3 cases,intestinal diverticulum for 3 cases, ulceration for 1 case,intestinal tumors for 6 cases,intestinal tumor complicated with intussusception for 2 cases,inflammatory process and injury for 6 cases as well as Crohn＇s disease for 2 cases. Nature of the diseases of 18 cases were surgically,pathologically or endoscopically confirmed. 4 cases of inflammatory hemorrhage were cured with conservative medical treatments. Conclusion： 16 detector-row spiral CT with dual-phase enhanced scan and relative reconstruction techniques was valuable for the evaluation of intestinal hemorrhage and helpful in the treatment planning as we

关 键 词：体层摄影术 X线计算机 小肠出血 双期扫描 成像 三维 

分 类 号：R816.5[医药卫生—放射医学]