急诊腹部CT对急性肠系膜血管栓塞的诊断作用  

Emergency CT in the diagnosis of acute mesenteric vascular occlusion

作　　者：汪良芝[1,2] 陈明[1,2] 

机构地区：[1]浙江省常州市第一人民医院 [2]苏州大学附属第三医院,浙江常州213003

出　　处：《吉林医学》2011年第31期6548-6549,共2页Jilin Medical Journal

摘　　要：目的:探讨急诊腹部CT对急性肠系膜血管栓塞(AMVO)的诊断作用。方法:回顾性分析行急诊腹部CT的45例AMVO患者,结合临床特征和CT表现,判断急诊腹部CT对AMVO的诊断作用。结果:45例AMVO患者中,38例患者通过急诊腹部CT确诊,确诊率为84.4%,3例患者通过剖腹探查确诊,4例患者行肠系膜血管造影确诊。诊断肠系膜上动脉栓塞24例,肠系膜下动脉栓塞1例,肠系膜上静脉栓塞9例,肠系膜血管栓塞11例。AMVO的CT直接征像为血管内充盈缺损(38例),间接征象包括肠腔扩张积液(11例)、肠壁增厚(26例)、薄纸样肠壁(4例)、缆绳征(5例)、肠系膜积液(13例)及腹腔积液(18例)。结论:急诊腹部CT对急性肠系膜血管栓塞有很好的诊断作用。Objective To evaluate emergency CT in the diagnosis of acute mesenteric vascular occlusion（AMVO）.Method A retrospective analysis was made on the clinical data of 45 patients with AMVO who were performed with emergency CT.Results In 45 cases of AMVO,38 cases were diagnosed by emergency CT,3 cases by laparotomy and 4 cases by selective angiography.There were 24 cases of superior mesenteric artery embolism,one case of inferior mesenteric artery thrombosis,9 cases of superior mesenteric vein thrombosis,and 11 cases of mesenteric vascular embolism.The direct sign of acute mesenteric occlusion in CT images was filling defect in mesentery vessels（n=38）.The indirect signs included dilatation of bowl loops（n=11）,bowel wall thickening（n=26）,the paper-thin wall sign（n=4）,mesenteric stranding（n=5）,mesenteric haziness（n=13） and ascites（n=18）.Conclusion Emergency CT is useful in the diagnosis of acute mesenteric vascular occlusion.

关 键 词：肠系膜血管栓塞 诊断 急诊腹部CT 

分 类 号：R657.2[医药卫生—外科学]