口服低张等渗甘露醇法MSCT小肠造影的正常表现  

The normal manifestation of MSCT enterography with iso-osmia mannitol at hypotonicity

作　　者：何伯圣[1] 龚沈初[1] 盛美红[1] 王林[1] 唐军华[1] 黄胜[1] 

机构地区：[1]南通市第一人民医院影像科,江苏226001

出　　处：《交通医学》2013年第4期323-326,共4页Medical Journal of Communications

基　　金：南通市社会事业科技创新与示范计划(HS2011018)

摘　　要：目的:总结口服低张等渗甘露醇法MSCT小肠造影的正常表现。方法:回顾性研究20例在我院行MSCTE患者的影像资料,所有病例经临床及影像学诊断消化系统无明显病变,且排除恶性肿瘤、自身免疫性疾病、肝硬化、心功能衰竭、精神病以及碘过敏。使用Siemens Somatom Sensation 64层螺旋CT和370(370mgI/mL)静脉对比剂进行检查,后处理方法包括:多平面重建(multi-planar reconstruction,MPR)、最大密度投影(maximum intensity projection,MIP)、容积再现技术(volume rendered technique,VRT)、曲面重建法(curved planar reformation,CPR)。由两名主治医师以上的专于胃肠道影像诊断的医师,对正常组病例的肠管充盈直径、肠壁CT值和肠壁厚度进行测量,并对小肠缘系膜动脉血管进行统计。结果:本组正常小肠MSCTE的平均充盈直径为(18.3±3.7)mm,各段肠管之间充盈无差异;正常小肠肠壁平均厚度为(2.3±0.4)mm,各段肠管之间肠壁厚度无差异(P>0.05);正常小肠平扫、动脉期、静脉期的CT值分别为(29.1±2.0)Hu、(61.0±2.8)Hu、(79.1±4.7)Hu,同一时相各段肠管之间CT值无差异(P>0.05),而同一组段各期小肠CT值有差异(P<0.05);肠系膜上动脉四级以上分支(小肠缘系膜血管)的显示率为81.7%(49)。结论:MSCT检查能清晰显示小肠壁结构及肠缘血管,对正常小肠MSCTE表现的探讨有助于小肠疾病的诊断与鉴别诊断。Objective：To summarize the normal manifestations of MSCT enterography（MSCTE） with iso-osmia mannitol at hypotonicity. Methods：Retrospective analysis was made on 20 patients with both normal clinical and imaging diagnosis and the exclusion criteria includes malignancy, connective tissue disease, liver cirrhosis, heart failure, psychosis and allergic to iodine. Post processing such as MPR, MIP, VRT and CPR was used on Siemens Somatom Sensation 64-slice Spiral CT images with 370 iodine（370mgI/ml）. The diameter of filling bowel, CT attenuations and thickness of intestinal wall were measured and superior mesenteric arteries of distal end were counted by two gastrointestinal radiologists. Results：On MSCTE images the average diameter of filling bowel was（18.3±3.7）mm, the average bowel thickness was（2.3±0.4）mm, the average CT attenuation of plain scan, artery phase and portal phase was（29.1±2.0）Hu,（61.0±2.8）Hu and（78.7±5.0）Hu. There was no notable difference at diameter of filling bowel and bowel thickness among the groups of small bowel（P0.05）. No notable difference was found at the average CT attenuation among the groups of small bowel in every phase（P0.05）, but the difference of CT attenuation at every group was significant among the phases（P0.05）. A display rate of81.7%（49/60） of the superior mesenteric arteries of distal end was found in all cases. Conclusion：The structure and blood circulation of intestinal wall could be displayed clearly on the images of MSCTE, and the study of the normal manifestations of MSCT enterography was helpful for the diagnosis and differential diagnosis of the small bowel.

关 键 词：MSCT 正常 小肠 表现 小肠造影 

分 类 号：R814.43[医药卫生—影像医学与核医学]