肠石性小肠梗阻的CT诊断  

The CT Diagnosis of Enterolith Obstruction of Small Intestine

作　　者：刘洪杰[1] 孙浩然[1] 汪俊萍[1] 李琼[1] 韩树高[1] 曲方圆[1] 

机构地区：[1]天津总医院,天津300052

出　　处：《中国医学影像学杂志》2011年第4期287-291,共5页Chinese Journal of Medical Imaging

摘　　要：目的分析肠石性小肠梗阻的特征性CT表现,评估CT对肠石性肠梗阻的诊断价值。资料与方法对21例手术或临床证实的肠石性小肠梗阻CT表现进行回顾性分析,由2位主治医生盲法对21例患者以及其他17例粘连性肠梗阻图像共同作出诊断。结果 16例胃石性肠梗阻均在梗阻移行处肠腔内见边界清楚的含气致密团块,10例见周边硬化缘,8例伴周围肠壁局部增厚,4例伴胃石,2例伴近端小肠扭转。胆石性肠梗阻5例,异位结石表现为环状钙化或完全钙化影,4例伴有胆囊形态异常及胆道积气。21例肠石性肠梗阻中17例诊断正确,CT对肠石性肠梗阻诊断阳性预测值为100%,阴性预测值为81.0%,敏感性为81.0%,特异性为100%,准确性为89.5%。结论 CT能明确显示肠石性小肠梗阻的特征表现,是诊断肠石性小肠梗阻的可靠手段。Purpose To analyze the of computed tomography（CT）features of small intestine enterolith obstruction and to investigate the diagnostic value.Materials and Methods The CT findings of 21 cases of enterolith intestinal obstruction proved by operations or clinically were retrospectively analyzed.Two attending radiologists,blinded to patient clinical information,read the CT images of these 21 patients along with 17 cases of adhesive ileus to make a diagnosis by consensus.Results For all the 16 cases of gastric bezoar intestinal obstruction,well-defined,gas-containing concretions were found in the intraluminal transitional zone of the obstruction.In these 16 cases,10 were associated with peripheral hardening;8 showed local thickening of intestinal wall;4 had gastric bezoars,and 2 were associated with proximal intestinal volvulus.For all the 5 cases of gallstone ileus,the ectopic gallstones showed either ring-calcification or total-calcification,of which 4 were combined with abnormal gallbladder and billiary pneumatosis.The radiologists correctly diagnosed 17 of 21 cases.The positive predictive value,negative predictive value,sensitivity,specificity and accuracy of CT in diagnosing enterolith intestinal obstruction were 100%,81.0%,81.0%,100% and 89.5% respectively.Conclusions Gastric bezoars and ectopic gallstone intestinal obstruction have characteristic CT manifestations.Computed tomography is reliable in the diagnosis of enterolith obstruction of small intestine.

关 键 词：胃肠结石 肠梗阻 体层摄影术 X线计算机 

分 类 号：R574.204.54[医药卫生—消化系统]