多层螺旋CT及重组技术在肠系膜静脉血栓中的应用  

Clinical application of multi-slice spiral computed tomographic scanning and reconstruction technology in diagnosis of mesenteric venous thrombosis

作　　者：焦志云[1] 李澄[1] 李代欣[1] 张勇[1] 刘淑惠[1] 

机构地区：[1]扬州市第一人民医院影像科,江苏扬州225009

出　　处：《胃肠病学和肝病学杂志》2012年第12期1143-1146,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨128层螺旋CT及重组技术对肠系膜静脉血栓的诊断价值。方法回顾性分析16例经手术及临床确诊的肠系膜静脉血栓形成患者的128层螺旋CT影像表现,其中14例行增强扫描,并应用多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)和容积再现(VR)技术进行处理。结果 14例肠系膜静脉不同程度增粗,10例肠系膜周围脂肪密度增高呈"脂肪浑浊征",7例管腔内高密度影,13例肠壁增厚水肿,5例肠管扩张、积液积气,10例有不同程度腹腔积液;14例增强扫描中12例显示肠系膜上静脉或肠系膜下静脉及门静脉内低密度充盈缺损呈"靶征",9例肠管管壁强化呈"双环征",3例肠管未强化,2例发生于末梢血管的病变CT未能直接显示血栓,扫描显示了肠管扩张、肠壁增厚、肠壁强化程度减低或肠间小气泡影及门静脉积气等反映继发肠缺血表现的CT征象。结论 128层螺旋CT平扫、增强扫描及三维重组技术相结合是诊断肠系膜静脉血栓的一种有效且无创的影像检查方法,可以明确血栓的部位及范围,对临床治疗有较高的指导价值。Objective To evaluate the clinical value of 128-slice spiral computed tomographic scanning and reconstruction technology in diagnosis of mesenteric venous thrombosis.Methods 128-slice spiral CT features of mesenteric venous thrombosis in 16 patients with surgery and clinical diagnosis were retrospectively analyzed.14 cases underwent scanning after contrast agent administration,post-processing techniques including multiplanar reformation（MPR）,curved planar reformation（CPR）,maximum intensity projection（MIP） and volume rendering（VR）.Results Its finddings inculded different extent of mesenteric vein widened in 14 cases.Fat opacity sign was shown with mesenteric fat density raised in 10 cases.High density of vein in 7 cases.Bowel wall thickened and edema in 13 cases.Pneumatosis and effusion in distended intestine in 5 cases.Different extent of ascites in 10 cases.After administration of contrast material,the filling defects of superior mesenteric vein and/or inferior mesenteric vein and portal vein could be showed in 12 cases presenting target sign.Bowel wall enhanced presenting double loop sign in 9 cases,but bowel wall were not enhanced in 3 cases.The distal mesenteric venous thrombosis was occluded in other 2 patients.The thrombi could be directively showed by CT,but distended bowel loops,bowel wall thicking absent or poor enhancement of the bowel wall,and the pneumatosis at nterbowel and portal venous were showed by CT.Conclusion 128-slice spiral CT scanning and 3-dimensional reconstruction combined is an effective non-invasive method for the diagnosis of mesenteric venous thrombosis,which shows the definite position and extent of thrombosis and is valuable in guiding clinical treatment.

关 键 词：肠系膜静脉 血栓形成 体层摄影术 X线计算机 

分 类 号：R572.3[医药卫生—消化系统]