MSCT 增强扫描诊断胃肠道血管畸形的价值  

The value of MSCT in diagnosis of gastrointestinal vascular malformation

作　　者：邓灵波 李晓光[1] 孙昊[1] 王志伟[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院放射科,北京100730

出　　处：《实用放射学杂志》2015年第6期942-946,共5页Journal of Practical Radiology

摘　　要：目的：探讨胃肠道血管畸形（GIVM）患者的多层螺旋 CT（MSCT）增强扫描表现,评估 MSCT 增强扫描对其的诊断价值。方法分析本院最终诊断为 GIVW 的 MSCT 增强扫描图像,观察病变血管的部位、起源与走行,结合各种 CT 后处理方法分析病灶的影像特点。结果44例行 MSCT 增强检查的 GIVM 患者阳性26例（59.1%）,阴性18例（40.9%）。MSCT 阳性病变中1例（2.3%,1/44）病变呈弥漫分布,1例（2.3%,1/44）病变呈多灶性分布,2例（4.5%,2/44）表现为对比剂外溢,6例（13.6%,6/44）表现为肠壁异常强化伴肠周多发迂曲增粗的血管影,10例（22.7%,10/44）例表现为肠壁局部结节状异常强化,6例（13.6%,6/44）表现为肠周小血管影增多。24例局限形病变中胃壁2例,十二指肠1例,空肠10例,回肠3例,回盲部1例,结肠2例,乙状结肠-直肠5例。结论MSCT 增强检查能准确显示胃肠道血管畸形的部位、范围、形态及影像特点,对指导治疗 GIVW 引起的消化道出血有良好的临床应用价值。Objective To explore the characteristics of gastrointestinal vascular malformation on contrast-enhanced multi-slice spiral computed tomography（MSCT）and assess the value of MSCT in diagnosis of gastrointestinal vascular malformation.Methods Forty-four patients with the final diagnosis of gastrointestinal vascular malformation were collected and analyzed retrospectively.We summarized the characteristics of contrast-enhanced MSCT in gastrointestinal vascular malformation and evaluated the value of MSCT in the diagnosis of gastrointestinal vascular malformation combined with image reconstructions such as MPR,MIP and VRT. Results Among 44 cases who received contrast-enhanced MSCT examination,18 cases were negative（40.9%）,26 cases had positive signs（59.1%）.In the 26 cases,1 case with diffuse lesions,1 case with multiple lesions,the others were local-type cases,in which 2 cases were showed contrast medium extravasations,6 cases were not only showed local mural hyper-intensification,but also multi-ple dilated small vessels around intestinal tract,10 cases were showed only local mural hyper-intensification,6 cases were showed only multiple dilated small vessels around intestinal tract.In the 24 local-type cases,lesions located at the stomach in 2 cases,the du-odenum 1 case,the jejunum 10 cases,the ileum 3 cases,the ileocecal junction 1 case,the colon 2 cases,the sigmoid colon-rectum 5 cases,respectively.Conclusion Contrast-enhanced MSCT can show the location,extent,patterns features of gastrointestinal vascu-lar malformation.It is helpful for detection and localization of the gastrointestinal vascular malformation with gastrointestinal bleed-ing.

关 键 词：胃肠道血管畸形 消化道出血 计算机体层成像 

分 类 号：R572[医药卫生—消化系统] R573[医药卫生—内科学]