老年血管源性急腹症患者多层螺旋CT特征及其临床意义  

Research of diagnostic meaning of multislice spiral CT angiography to elderly patients with acute abdominal vascular disease

作　　者：曾茹雪[1] 黄文[1] 唐继芳[1] 钏冬媚[1] 刘婷[1] 刘倩[2] 

机构地区：[1]德阳市人民医院放射科,四川德阳618000 [2]德阳市人民医院病理科,四川德阳618000

出　　处：《西部医学》2015年第12期1863-1866,共4页Medical Journal of West China

基　　金：四川省卫生厅科研课题(130438)

摘　　要：目的探讨急诊老年血管源性急腹症患者的多层螺旋CT表现特征及其诊断意义。方法选取本院急诊科2014年2月～2015年2月通过临床或手术确诊为老年血管源性急腹症的40例患者作为研究对象，40例患者均采用多层螺旋CT进行平扫和增强扫描，采用多种血管成像的方法对血管进行成像，其中包括曲面重组法（CPR）、容积再现法（VR）、最大密度投影法（MP）及多平面重组法（MPR），分析多层螺旋CT表现特征，并与临床结果进行对比。结果40例血管源性急腹症患者经多层螺旋CT成像，最终诊断出腹主动脉瘤6例，肾动脉主干及分支栓塞4例，主动脉夹层7例，门静脉广泛癌栓塞6例，肠系膜上静脉血栓塞5例，肠系膜上动脉血栓塞4例，髂动脉瘤合并出血5例，肠系膜结构扭转3例，均经临床或手术确诊。结论老年血管源性急腹症患者采用多层螺旋CT进行血管成像对于疾病’的诊断具有重要意义，其主要针对血管源性急腹症的病变范围及其定位情况，对临床医生的正确治疗具有较高的临床价值，临床上可将其作为血管源性急腹症的首选检查手段。Objective To explore the diagnostic meaning of multisliee CT angiography to elderly patients with a- cute abdominal vascular disease. Methods 40 elderly patients with acute abdominal vascular disease from 2014. 2 to 2015.2 in the hospital were chosen as the research subjects. All of the patients in the research were determined through clinic or clinical vascular surgery. All of their clinical data were retrospectively analyzed. All the patients were given the test of multislice spiral CT scan and the enhanced scan, and then they were examined by a variety of angiography exami- nations, such as curved planar reformation （CPR）, multi-planar reconstruction, volume rendering and maximum intensity projection. All their hospital imaging data were completely preserved. Results 40 cases of acute abdomen caused by vas- cular lesions in patients with multi-slice spiral CT imaging. There were 6 cases with abdominal aortic aneurysm and 4 ca- ses with renal artery and its branch embolization, 7 cases with aortic dissection, 6 cases with portal venous embolism of carcinoma, 5 cases with superior mesenteric vein thrombosis, 4 cases with superior mesenteric artery thrombosis, 5 cases with iliac artery aneurysm complicated with hemorrhage, 3 cases with mesenterie structure torsion. They were confirmed by operation and clinic diagnosis. Conclusion There is a significant value in multislice CT angiography for the diagnosis of age-related abdominal vascular disease to ensure the localization of the acute abdominal vasculogenic diseases and delin- eation of the extent disease. Multislice spiral CT examination could be the first choice for patients with abdominal vascu- lar disease.

关 键 词：急诊 老年血管源性急腹症 多层螺旋CT 血管成像 临床意义 

分 类 号：R656.1[医药卫生—急诊医学] R445.3[医药卫生—外科学]