急性肠系膜血管梗塞的CT平扫表现  

CT manifestations of acute mesenteric infarction

作　　者：赖海平[1] 

机构地区：[1]开平市中心医院放射科,广东开平529300

出　　处：《海南医学》2013年第1期44-46,共3页Hainan Medical Journal

摘　　要：目的分析多例急性肠系膜上动静脉血管梗塞病例的螺旋CT平扫影像改变，提高对本病影像表现的认识。方法收集12例手术或造影证实的肠系膜动脉或静脉梗塞的急诊病例，年龄36～64岁，其中肠系膜上动脉梗塞7例，肠系膜上静脉梗塞5例，均做螺旋CT平扫。结果肠系膜上动脉梗塞：7例有不同程度梗阻近段增粗远侧段变细；5例增粗血管腔内密度增高；2例局部肠管扩张呈纸样变薄；1例有少量腹水；2例肠系膜局部密度增高；6例见增粗侧枝循环血管。肠系膜上静脉梗塞：5例均见绳索征及增粗静脉密度不同程度增高。均有局部肠管壁不同程度增厚，3例呈双环征。1例肠壁出现积气。5例局部肠系膜密度增高。2例有少量游离腹水。结论急性肠系膜上动静脉栓塞CT平扫有较特征的表现，正确认识这些征象可以让患者得到及时诊治，提高患者的生存率。Objective To analyze the spiral CT manifestations of patients with acute mesenteric infarction （AMI）, and to improve the awareness of imaging manifestations of the disease. Methods Twelve patients with AMI confirmed by surgery or angiography, aged from 36 to 64 year old, underwent CT scan of the abdomen and pel- vis, including 7 patients of superior mesenteric artery occlusion and 5 patients of superior mesenteric venous infarc- tion. Results CT findings for detection of superior mesenteric artery occlusion： 7 patients showed different degrees of obstruction with proximal wall thickening and distal wall thinning of artery; 5 patients showed higher density in their thickening sectional area of vessel lumen; 2 patients showed local intestinal dilatation with pattern thinning bow- el wall; 1 patient had a small amount of ascites; 2 patients revealed higher density in their mesentery; 6 cases showed thickening collateral circulation in blood vessels. CT findings for detection of superior mesenteric venous infarction： 5 patients displayed ＂cord sign＂ and varying degrees of higher density in their thickening sectional area of vessel lumen, as well as different degrees of thickening of their vessel wall; 3 patients showed ＂double-ring sign＂; 1 patient had pneumatosis of bowel wall; 5 patients revealed higher density in their mesentery; 2 patients had small amounts of ascites. Conclusion AMI has some characteristic CT performances. Correct understanding of these signs allows patients to receive timely diagnosis and treatment to improve the survival rate.

关 键 词：肠缺血 肠系膜动静脉 X线计算机体层成像. 

分 类 号：R445.2[医药卫生—影像医学与核医学]