梗阻与非梗阻性小肠粪石的MSCT特征  

Comparison on MSCT characteristics between small bowel bezoars with or without obstruction

作　　者：江岷芮[1] 赵明泽[2] 王毅[1] 陈金华[1] 李然[1] 冉启胜[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042 [2]中国人民解放军第273医院放射科,新疆库尔勒841000

出　　处：《中国医学影像技术》2013年第6期936-940,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81071145)

摘　　要：目的探讨梗阻与非梗阻性小肠粪石的MSCT特征。方法收集MSCT检查发现的42例小肠粪石患者,按是否继发有小肠梗阻分为梗阻组和非梗阻组,比较两组粪石的不同MSCT特征。结果梗阻组23例,粪石位于空肠7例、回肠15例、阑尾1例;非梗阻组19例,粪石位于空肠7例、回肠9例、阑尾3例。梗阻组中钙质粪石5例、植物性粪石17例、毛粪石1例,非梗阻组中17例为钙质粪石、2例为植物性粪石,两组粪石类型的比较差异有统计学意义(χ2=19.18,P<0.01)。梗阻组粪石平均长径为(3.12±1.14)cm,大于非梗阻组[(1.53±0.96)cm,t=4.83,P<0.01)]。两组粪石平均CT值[梗阻组(58.45±21.65)HU,非梗阻组(171.68±61.77)HU]差异也有统计学意义(t=8.22,P<0.01)。结论小肠粪石的类型和大小是能否继发梗阻的主要因素;MSCT能区分不同类型粪石,全面评估粪石性小肠梗阻病情。Objective To explore MSCT characteristics of small bowel bezoars with and without obstruction. Methods Forty-two patients with small bowel bezoars detected by MSCT were selected and divided into obstructive group and non- obstructive group according to with or without small bowel obstruction. MSCT characteristics of the bezoars between the two groups were compared. Results The locations of the bezoars in obstructive group and non-obstructive group were the jejunum in 7 patients respectively, the ileum in 15 and 9 patients respectively, and the appendix in 1 and 3 patients respectively. Obstructive group included phytobezoar in 17 patients, calcareous bezoar in 5 patients and trichohezoar in 1 patient respectively, while calcareous bezoar in 17 and phytobezoar in 2 patients in non-obstructive group. The difference of the bezoar types between the 2 groups was significant （X2 = 19.18, P〈0.01）. Diameter of bezoar in obstructive group （[3. 12 ± 1.14]cm） was larger than that in non-obstructive group （[1.53±0.96]cm, t=4.83, P〈0.01）. The difference of CT val ue between the 2 groups was statistical （t=8.22, P〈0.01）. Conclusion The type and size of the small bowel bezoars are the main causes to result in obstruction. MSCT can distinguish different types of small bowel bezoars and provide accurate and overall evaluation on small bowel bezoar causing obstruction.

关 键 词：肠梗阻 胃肠石 体层摄影术 X线计算机 比较研究 

分 类 号：R575.7[医药卫生—消化系统] R814.42[医药卫生—内科学]