腹腔内疝MSCT诊断和手术结果对照分析  

Comparative Analysis between the MSCT Diagnosis of Abdominal Internal Hernia and the Result of Operation

作　　者：张田荪[1] 沈比先[1] 喻军[2] 褚千琨[1] 张大波[1] 

机构地区：[1]广东医学院附属南山医院医学影像科,广东深圳518052 [2]广东医学院附属南山医院胃肠外科,广东深圳518052

出　　处：《中国CT和MRI杂志》2012年第5期67-70,共4页Chinese Journal of CT and MRI

摘　　要：目的分析探讨腹内疝多层螺旋CT(以下简称MSCT)表现,对照手术结果,提高对本病影像学认识。方法对照分析经手术证实的22例腹内疝患者的临床及CT资料。结果 22例腹内疝20例表现为小肠梗阻;1例结肠梗阻;1例大网膜游离缘疝,疝入组织为肠系膜,未见肠梗阻,可见肠系膜动脉增粗、移位;其中7例为绞窄性小肠梗阻并腹腔积液。特征性CT表现为肠形态异常、肠管移位、扩张肠袢呈肿块状、囊袋状、簇状聚集;肠系膜根部血管增粗、曲张,牵拉、移位,肠系膜皱缩呈条状,血管及皱缩条状肠系膜向疝口部位集中。手术结果大网膜疝2例;大网膜游离缘疝1例;小肠系膜疝7例;肠粘连索带疝9例;盆腔内疝2例;乙状结肠隐窝疝1例。各种类型腹内疝的MSCT表现与手术结果存在相关性。结论通过仔细分析CT征象和对照手术结果,MSCT对大多数腹内疝能做出正确诊断,可有效指导手术方案的选择。Objective To evaluate the value of Spiral CT in diagnosing of internal abdomi- nal hernia compared with operation. Methods Analyse the clinical and CT data of 22 internal abdominal hernia proved by operation. Results CT imagings of 21 cases show intestinal obstruction,7 cases of which show strangulating intestinal obstruction and ascites. The typical expressions of CT images are as the following： the shape of intestines are abnormal and the position are translocated; intestinal loops are gathered with different forms： blood vessels of mesenteries are expanded, tractive and translocated：Mesentery is shrinking as a strip; blood vessels and shrinking mesenteries are togethered at the entrance of hem.2 cases of omental sac hernias, I case of omental sac free margin hernia,7 cases of transmesenteric hernias,9 cases of ankylenteron strap hernias, 2 cases of pelvic hernias and 1 case of sigmoid recess hernia proved by operation were collected.The CT imagings of internal abdominal hernia correlated with indication of operation. Conclusion Spiral CT may help to make accurate diagnosis in major internal abdominal hernias and design operative plan.

关 键 词：腹内疝 肠梗阻 多层螺旋 CT 手术 

分 类 号：R57[医药卫生—消化系统] R814.42[医药卫生—内科学]