非新生儿小儿肠旋转不良的影像诊断价值  

The image diagnostic value of intestinal malrotation in non-neonatal patients

作　　者：陈伟[1] 胡经纬[2] 谢筱筱[1] 陈裕[1] 何家维[1] 付玉川[1] 刘锟[1] 严志汉[1] 

机构地区：[1]温州医学院附属第二医院放射科,浙江温州325027 [2]温州医学院附属第二医院普外科,浙江温州325027

出　　处：《医学影像学杂志》2013年第5期742-745,共4页Journal of Medical Imaging

摘　　要：目的探讨非新生儿小儿肠旋转不良(malrotation of intestine)的影像表现,提高对本病的认识及诊断水平。方法回顾分析18例经手术证实的非新生儿小儿肠旋转不良的X线及CT表现,18例均行CT检查,其中10例行上消化道造影,11例行钡剂灌肠,另有8例行增强CT扫描。结果上消化道造影示十二指肠不完全梗阻6例;钡灌肠示回盲部位于右上腹2例,中上腹4例,左上腹3例;CT显示肠系膜根部类团块影,5例增强扫描可见典型"漩涡征",提示伴有中肠扭转,毗邻肠袢扩张,肠系膜静脉不同程度淤积扩张,18例患儿术前及术后均诊断为肠旋转不良,诊断准确率为100%。结论上消化道造影、CT平扫及增强扫描对非新生儿小儿肠旋转不良的诊断具有重要价值,对于不明原因的反复呕吐及腹痛的患儿应及时对其进行上述影像学检查。Objective To investigate the imaging findings of intestinal malrotation in non-neonatal patients so as to improve the understanding and diagnosis of the disease. Methods 18 cases of intestinal malrotation in non-neonatal patients proved by surgery were analyzed retrospectively. Upper gastrointestinal barium radiography wree found in 10 cases, barium enema in 11 cases, and CT in 18 cases, contrast enhancement CT in 8 cases simultaneously. Results Incomplete obstruction of duodenal were found in 6 cases; Barium enema： Ileocecal junction in the right upper quadrant were depicted in 2 cases, 5 cases in upper and middle abdomin, 2 cases in left upper quadrant; The whirl sign around the superior mesen- teric artery was found in 5 cases of contrast enhancement CT scanning. It suggested that accompanied with midgut volvulus. All the 18 cases were diagnosed with intestinal malrotation in the preoperative and postoperative, the diagnostic accu- racy was 100%. Conclusion Upper gastrointestinal radiography, CT Plain scan and enhanced scan can play an important role in the evaluation of intestinal malrotation in non-neonatal patients. The children, who have unexplained recurrent vomiting and abdominal pain, should be timely taken the imaging examination obve.

关 键 词：肠旋转不良 体层摄影术 X线计算机 非新生儿 

分 类 号：R814.42[医药卫生—影像医学与核医学] R725.7[医药卫生—放射医学]