多层螺旋CT在肠系膜上动脉栓塞诊断中的应用价值  

Application of Multi-slice CT in the Diagnosis of Superior Mesenteric Artery Embolization

作　　者：张银[1] 吴智玲[1] 周立强[1] 杨建平[1] 徐开鹏[1] 陈士花[1] 宋淮[1] 

机构地区：[1]沭阳县人民医院放射科,江苏省宿迁市223600

出　　处：《中国全科医学》2013年第9期1072-1074,共3页Chinese General Practice

摘　　要：目的探讨多层螺旋CT(MSCT)在肠系膜上动脉栓塞(SMAE)诊断中的应用价值。方法回顾性分析我院2006年4月—2011年11月收治的18例SMAE患者的临床及影像学资料,总结SMAE的MSCT影像学特征。结果 18例患者均行MSCT三期扫描,其中11例行数字减影血管造影(DSA)检查。MSCT判断肠系膜上动脉(SMA)主干栓塞准确率达100.0%(13/13);而5例SMA分支栓塞患者中,MSCT仅诊断出3例(3/5),2例可疑为SMAE,后行DSA证实。MSCT平扫见栓子呈低密度,与正常SMA不易区分;4例伴有肠腔扩张征象,无腹腔积液、肠梗阻等征象。增强扫描显示13例患者SMA主干内充盈缺损影,其中6例SMA主干栓塞的患者可见栓子周围点状、椭圆形或弧形增强影,为不完全栓塞;5例SMA分支栓塞的患者见分支充盈缺损影,均为完全栓塞。数据后处理及图像重建:13例SMA主干栓塞的患者容积再现(VR)能够良好地显示空间关系,且能很好地显示血管的大体形态及其周围关系;3例患者最大密度投影(MIP)可见血管壁的斑块形成。多平面重建(MPR)及曲面重建(CPR)对于血管腔的显示更加直观。结论 MSCT及后处理技术能够无创、快速、准确地诊断SMAE,为SMAE的病情评估提供可靠信息。Objective To investigate the value of multi - slice CT （MSCT） in diagnosis of superior mesenteric artery embolization （SMAE） . Methods Clinical and imaging data of 18 SMAE patients admitted to our hospital from April 2006 to November 2011 were retrospectively analyzed to summarize the MSCT imaging characteristics of SMAE. Results All the 18 pa- tients were given MSCT three - phase scan, and 11 patients were also given DSA test. The accuracy of MSCT in predicting trunk embolism of SMA was 100. 0% （13/13） , while the accuracy of MSCT in predicting branch embolism was 60% （3/5） , and 2 cases were suspected of SMAE and then confirmed by DSA. MSCT plain scan showed that the embolus was low density and could not be easily differentiated from normal SMA. 4 cases were combined with gut cavity expansion, but without seroperitoneum or in- testinal obstruction. Enhancement scan showed that 13 cases had filling defects of SMA trunk, and dotted or oval enhanced shadow were seen in 6 incomplete SMA trunk embolism cases and filling defect shadow were seen in 5 complete branch embolism ca- ses. Data post- processing and image reconstruction showed that volume rendering （VR） of the 13 SMA trunk embolism cases could well demonstrate space relationship and could welt demonstrate the shape of blood vessels and their relationship with sur- roundings. MIP of the 3 cases showed the formation of plaque on blood vessel wall. Multi - planar reconstruction （MPR） and curve planar reformation （CPR） could demonstrate vessel lumen more directly. Conclusion MSCT and post - processing tech- nology is non- invasive, and can diagnose SMAE rapidly and accurately, providing reliable information for assessing the condi- tion of SMAE.

关 键 词：肠系膜上动脉 栓塞 体层摄影术 螺旋计算机 

分 类 号：R572.3[医药卫生—消化系统]