256层多排螺旋CT小肠成像(MDCTE)对小肠梗阻性病变的临床应用研究  

Application of 256 Multidetector-row Computed Tomography Enterography (MDCTE) in Small Bowel Diverticulum and Obstruction

作　　者：解骞[1] 窦娅芳[2] 梁宗辉[3,4] 朱全东[1] 祝瑞江[1] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]上海交通大学附属第一人民医院放射科,上海200080 [3]上海市静安区中心医院放射科 [4]复旦大学附属华山医院静安分院,上海200040

出　　处：《生物医学工程学进展》2013年第1期10-14,共5页Progress in Biomedical Engineering

摘　　要：对24例临床怀疑小肠梗阻的患者行256-MDCTE平扫及增强扫描,通过横断面及多平面重建,观察梗阻部位、形态及周围肠壁情况。结果 24例均诊断为小肠梗阻,其中腹内外疝9例,表现为肠腔通过腹股沟、闭孔、膈肌及结肠系膜疝出,近端小肠扩张;小肠扭转6例,小肠粘连性梗阻2例,幽门梗阻2例,胆石症2例,因肿瘤肠壁增厚致不全性梗阻2例,因克隆恩病肠壁增厚引起不全性小肠梗阻1例。根据梗阻部位不同,可发现"分界移行带"、"漩涡征"、"鸟嘴征"、"靶征"等特征性及原发疾病的表现。证明小肠梗阻在MDCTE上具有特征性的表现,MDCTE能全景式、多方位展示小肠肠道、肠系膜和系膜血管,对小肠梗阻的诊断具有重要价值。24 patients with symptoms of suspected small bowel diseases underwent 256 - MDCTE. The CT appearances characteristic of small - bowel tumor, inflammatory bowel disease and other conditions affecting the small bowel are described and illustrated in detail. Associated complications and extraenteric manifestations also are described. There were 24 cases of small bowel obstruction. MDCTE depicting the features include simple obstruction patterns （single abrupt transition zone, beak sign, ＂ fat notch＂ sign）, patterns of closed -loop obstruction （two adjacent beaks, C -shaped bowel, radial distribution of mesenteric vessels）, the location of the obstruction in the abdominal cavity, and the presence of a whirl sign and a ＂ small - bowel feces＂. Our results demonstrated that MDCTE with peroral and intravenous contrast is useful in assessing small bowel diseases; however,further studies are needed to determine and validate the full diagnostic and clinical potential of bowel imaging at MDCTE.

关 键 词：小肠 多层螺旋CT 小肠疾病 

分 类 号：R816.5[医药卫生—放射医学]