评估改良后的CT检查在小肠不全梗阻性疾病中的诊断价值  

The diagnostic value of the multi-slice computed tomography with appropriate amount isosmotic mannitol negative contrast in small bowel incompleteness obstruction

作　　者：公佩友[1] 李军霞[1] 刘奉立[1] 隋言宾[1] 王锡明[2] 

机构地区：[1]烟台毓璜顶医院影像科,山东烟台264000 [2]山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2014年第9期1534-1536,1540,共4页Journal of Medical Imaging

摘　　要：目的 探讨适量引入等渗甘露醇阴性对比剂后,多层螺旋CT对小肠有无不全梗阻、梗阻部位、梗阻原因的诊断价值.方法 收集我院2012年1月～2013年7月经手术或临床证实的小肠不全梗阻病例30例,其中男18例,女性12例,年龄31～77岁,平均年龄52岁.该组病例均在密切结合临床的情况下,适量引入等渗甘露醇阴性对比剂,为明确病因诊断,其中行增强扫描者8例,扫描范围从膈顶至耻骨联合水平.结果 ①CT检查诊断有无梗阻的敏感性为100％;②明确梗阻部位的准确率达90％,其中3例低位不全梗阻误诊为高位梗阻;③梗阻病因的诊断正确率为86.7％.结论 适量引入等渗甘露醇阴性对比剂后,多层螺旋CT在诊断有无小肠不全梗阻、梗阻部位、梗阻病因方面具有重要价值.Objective In order to study the diagnostic value of the multi-slice computed tomography with appropriate a- mount isosmotic mannitol negative contrast in small bowel incompleteness obstruction on the spect of the determination, existence, causes of the obstruction. Methods We collected 30 cases of small bowel obstruction with clinic or operation confirmed from January, 2012 to July, 2013 in our hospital, which included 18 males and 12 females. Their ages were be- tween 31 to 77, and the average age was 52. All the cases oraled appropriate amount isosmotic mannitol negative contrast under keeping closely consideration with clinical examnition. Among these cases, 8 cases performed contrasted examination for hunting the causes of the obstruction. Multi-slice computed tomography should scan from the diaphragmatic surface to the the pubic symphysis level continuously while the patient holds one breath. Results ① The existence of obstruction： the sensibility of CT is 100% in these 30 cases;② The determination of the obstruction： the accuracy rate is 90%. Ac- cording to the standards of diagnosis and depending on multi-planar reconstruction, there are 3 cases of low obstruction misdiagnosised as high obstructiong;③ The causes of obstruction： the accuracy rate of the causes of the disease is 86.7%. Conclusion With the appropriate isosmotic mannitol negative amount contrast, multi-slice computed tomography has very important value in the diagnosis of small bowel incompleteness obstruction on the spect of the determination, ex- istence, causes of the obstruction.

关 键 词：对比剂 多层螺旋CT 小肠 梗阻 

分 类 号：R814.42[医药卫生—影像医学与核医学]