320排动态容积CT血管成像在肠系膜血管缺血性疾病中的诊断价值  

The diagnostic value of 320-row dynamic volume CTA in mesenteric ischemia diseases

作　　者：潘春燕[1] PAN Chunyan(Department of Radiology,PLA Bethune International Peace Hospital,Shijiazhuang 050082,China)

机构地区：[1]中国人民解放军白求恩国际和平医院放射诊断科,河北石家庄050082

出　　处：《实用放射学杂志》2018年第12期1889-1892,共4页Journal of Practical Radiology

摘　　要：目的评价320排动态容积CT血管成像(CTA)在肠系膜血管缺血性疾病(MID)中的诊断价值。方法回顾性分析44例经数字减影血管造影(DSA)和手术证实的MID患者的临床资料和320排动态容积CTA影像资料,将320排动态容积CTA表现与DSA及手术结果进行对比。结果44例患者经320排动态容积CTA全部确诊为MID,确诊率100%,其中急性肠系膜缺血性疾病(AMI)32例,慢性肠系膜缺血性疾病(CMI)12例。根据DSA、外科手术结果确诊AMI患者28例,CMI患者16例。320排动态容积CTA对AMI直接与间接征象的诊断敏感性为100%,特异性为81.2%。其中,肠壁增厚、肠管扩张及肠壁强化缺乏是AMI最常见的征象(敏感性53.57%~71.43%,特异性75.00%)。肠壁菲薄、肠壁积气是AMI晚期、小肠坏死的特异性征象(敏感性14.28%~21.43%,特异性100%)。结论320排动态容积CTA是一种快速、有效、无创诊断MID的影像学方法,除直接显示血管病变外,还可以显示腹腔脏器的继发病变。Objective To evaluate the diagnostic value of 320-row dynamic volume computed tomgoraphy angiography (CTA)in mesenteric ischemia disease (MID).Methods Clinical data and 320-row dynamic volume CTA images of 44patients with MID confirmed by digital subtraction angiography (DSA)and surgery were analyzed retrospectively.The results of 320-row dynamic volume CTA were compared with DSA and surgical results.Results All 44patients were diagnosed as MID with 320-row dynamic volume CTA,with a diagnosis rate of 100%.Among them,32cases were of acute mesenteric ischemia (AMI),and 12cases were those of chronic mesenteric ischemia (CIVIl)disease.According to DSA and surgical results,28patients were diagnosed with AMI and 16patients with CiVil,with a sensitivity of 320- row dynamic volume CTA to direct and indirect sign AMI being 100%,and the specificity being 81.2%.Among them,thickening of the intestinal wall,expansion of the intestinal tube and lack of the strengthening of the intestinal wall were the most common sings of AMI (sensitivity 53.57%-71.43%,specificity 75.00%).Thinning of the intestinal wall and the intestinal wall pneumatosis were late sings of small intestine necrosis in the late stage of AIM/(sensitivity 14.28%-21.43%,specificity 100%).Conclusion 320-row dynamic volume CTA is a fast,effective and noninvasive imaging method for the diagnosis of MID.It can also display the secondary lesions of the abdominal viscera in addition to the direct display of vascular lesions.

关 键 词：计算机体层成像 血管造影术 肠系膜血管缺血性疾病 数字减影血管造影 

分 类 号：R814.42[医药卫生—影像医学与核医学] R814.43[医药卫生—放射医学]