多层螺旋CT血管造影及三维重建技术在肠系膜上静脉栓塞诊断中的临床价值  

Clinical value of multislice spiral CT angiography and three-dimensional reconstration in diagnosis of superior mesenteric venous thrombosis

作　　者：李玉林[1] 于昭[1] 程亚宝[1] 

机构地区：[1]中山大学附属梅州医院(广东省梅州市人民医院)放射科,广东梅州514031

出　　处：《医学影像学杂志》2011年第3期381-384,共4页Journal of Medical Imaging

摘　　要：目的：探讨多层螺旋CT血管造影及三维重建技术在SMVT诊断中的临床价值。方法：回顾分析我院2005年1月~2010年5月经手术证实的6例SMVT患者的16层螺旋CTA及三维重建资料,分析其CTA征象,对照术中所见及术后病理判断CTA及三维重建的临床价值。结果：直接征象：①CTA示SMV腔内充盈缺损、血管壁环形强化,本组6例均有显示,其中3例合并门静脉充盈缺损,3例合并SMV属支充盈缺损;②SMV增粗,6例SMV均增粗;③肠系膜上静脉腔内密度增高,本组有4例。间接征象：①肠系膜淤血肿胀4例;②肠管管壁水肿6例;③小肠梗阻征象2例;④腹水3例;⑤门静脉期肝强化不均匀4例。三维重建技术：MPR、MIP、VRT、VE对肠系膜上静脉及栓塞情况均显示良好。结论：多层螺旋CT血管造影及三维重建技术在SMVT诊断中具有重要临床价值,对于早期诊断和筛查具有重要意义。Objective：To explore the clinical value of multislice spiral CT angiography and three dimensional reconstruction in diagnosis of superior mesenteric venous thrombosis（SMVT）.Methods：Retrospective analysis of 6 cases with SMVT which were verified by surgery and pathology between January 2005 and May 2010 in our hospital.All cases had received 16-slice spiral CT angiography examination.Various post-processing three-dimensional reconstruction image were obtained and compared.Results：Direct sign： ① filling defect in SMV and venous wall ring-sharped enhancement were showed in 6 cases.Portal veins and branchs of SMV were involved by thrombus in 3 cases,respectively;② SMV were widened in all cases;③ High density of vein were revealed in 4 cases.Indirect sign： congested and edema of mesentery,intestinal wall thickening,intestinal obstruction,ascites,inhomogeneous attenuation in liver parenchyma in portal vein phase were showed in 4,6,2,3,and 4 cases.MPR,MIP,VRT and VE demonstrated SMVT clearly.Conclusion：Multislice spiral CT angiography and three-dimensional reconstrution play an important role in diagnosis SMVT.

关 键 词：MSCT CTA 三维重建 肠系膜上静脉栓塞 

分 类 号：R574[医药卫生—消化系统] R814.2[医药卫生—内科学]