绞窄性肠梗阻的多层螺旋CT征象  

Multi-slice Spiral CT Features of Strangulated Intestinal Obstruction

作　　者：杨栋梁[1] 刘红艳[1] 赖碧玉[1] 关秀红[1] 曲春瑜[1] 

机构地区：[1]清远市人民医院CT磁共振科,广东清远511500

出　　处：《中国医学影像学杂志》2016年第4期293-297,共5页Chinese Journal of Medical Imaging

摘　　要：目的绞窄性肠梗阻为急腹症之一,病死率高,本研究旨在探讨绞窄性肠梗阻的多层螺旋CT表现,提高术前CT诊断正确率。资料与方法经手术证实为绞窄性肠梗阻的43例患者(研究组),同期搜集97例单纯性肠梗阻作为对照组,比较两组的CT征象,分析CT征象诊断绞窄性肠梗阻的敏感度、特异度、阳性预测值和阴性预测值。结果 43例绞窄性肠梗阻中,肠扭转14例,腹内疝8例,闭孔疝4例,股疝17例。研究组CT表现为"鸟嘴征"43例,肠壁气泡4例,肠壁密度增高4例,肠壁强化减弱5例,"X征"8例,扩张肠袢壁增厚11例,肠壁内缘模糊5例,附属系膜血管扩张16例,闭袢16例,"漩涡征"13例,以上CT征象与对照组比较,差异均有统计学意义(P<0.05、P<0.001)。诊断绞窄性肠梗阻敏感度最高的CT征象为"鸟嘴征"(100.0%),特异度最高的CT征象为肠壁气泡、肠壁密度增高、肠壁强化减弱、"X征",均为100.0%。结论 "鸟嘴征"是诊断绞窄性肠梗阻最敏感的CT征象,肠壁气泡、肠壁密度增高、肠壁强化减弱、"X征"为绞窄性肠梗阻最特异的CT征象,扩张肠袢壁增厚、肠壁内缘模糊、附属系膜血管扩张、"漩涡征"、闭袢为绞窄性肠梗阻常见的CT征象。Purpose Strangulated intestinal obstruction is an acute abdomen with high mortality. This study is to explore the features of strangulated intestinal obstruction on multi-slice spiral CT so as to improve the accuracy of its CT diagnosis. Materials and Methods The CT images of 43 patients with strangulated intestinal obstruction confirmed by surgery（study group） and 97 patients with simple ileus diagnosed by operation（control group） were collected. The parameters of sensitivity, specificity, positive predictive value and negative predictive value of CT signs of the two groups were compared. Results Among the 43 patients of strangulated intestinal obstruction, 14 were with intestinal volvulus, 8 with abdominal internal hernia, 4 with obturator hernia, and 17 with femoral hernia. The CT scan displayed ＂beak＂ sign in all the 43 cases. Four cases had bubbles in wall; 4 cases had intestinal wall of hyperattenuation; 5 cases had weakened intestinal enhancement; 8 cases had ＂X＂ sign; 11 cases had dilated bowel thickening walls; 5 cases had blurred inner edge of bowel wall; 16 cases had mesenteric vasodilation; 16 cases had closed loop and 13 cases had ＂whirl＂ sign. All these CT features in study group showed significant differences from those in control group（P〈0.05, P0.001）. The ＂beak＂ sign was the typical CT feature with the highest sensitivity in strangulated intestinal obstruction（100.0%）. The features such as bubbles in the wall, hyperattenuation of intestinal wall, weakened intestinal enhancement and ＂X＂ sign were with the highest specificity（100.0%）. Conclusion As for strangulated intestinal obstruction, ＂beak＂ sign is the most sensitive CT feature of strangulated intestinal obstruction. Bubbles in wall, intestinal wall of hyperattenuation; weakened intestinal enhancement and ＂X＂ sign are the most specific CT features. It has other common CT features like dilated bowel thickening wall, blurredinner edge of bowel wall, mesenteric vasodilation, ＂whirl＂ sign and c

关 键 词：肠梗阻 体层摄影术 螺旋计算机 

分 类 号：R445.3[医药卫生—影像医学与核医学] R574.2[医药卫生—诊断学]