MSCT对缺血性肠病的诊断价值  

Effectiveness of Application of MSCT in Diagnosis of Intestinal Ischemia

作　　者：蔡红法[1] 杨骁驰 赵文娟[2] 钮恩斌 

机构地区：[1]南京医科大学附属苏州医院(苏州市立医院东区)放射科,江苏苏州215001 [2]苏州市中医医院放射科,江苏苏州215000

出　　处：《中国医疗设备》2016年第6期65-69,共5页China Medical Devices

摘　　要：目的分析缺血性肠病的多层螺旋CT(MSCT)表现,探讨MSCT对该病的诊断价值。方法回顾性分析30例经病理证实为缺血性肠病患者的临床资料和MSCT表现。结果在30例患者中,MSCT表现为肠壁增厚19例(其中表现为可逆性缺血17例,表现为不可逆性缺血2例),肠壁变薄8例(均表现为不可逆性缺血),肠壁无明显增厚或变薄1例,肠壁增厚与变薄并存2例。在可逆性肠缺血患者中,肠壁出现分层强化呈"靶征"11例,肠壁强化正常或增加3例,肠腔扩张、积液10例;在不可逆性肠缺血患者中,强化减弱或无强化7例,肠腔扩张、积液2例。在30例患者中,肠系膜水肿、浑浊22例,4例合并腹水;肠壁和/或门脉积气9例。结论肠系膜动脉狭窄或闭塞易导致肠系膜不可逆性缺血,通常可引起肠壁变薄;而可逆性肠系膜缺血多表现为肠壁不同程度的增厚。MSCT能快速、准确地诊断缺血性肠病,并能对其发病原因、病变范围、病情程度等作出准确评估。Objective To investigate the clinical effectiveness of application of multi-slice spiral CT（MSCT） in diagnosis of intestinal ischemia. Methods The MSCT findings in 30 patients with intestinal ischemia confirmed by clinic or pathology were retrospectively analyzed. Results Among 30 cases, 19 cases showed bowel wall thickening, of which 17 cases were reversible mesenteric ischemic and 2 cases were irreversible ones. 8 cases with thinner bowel wall were irreversible mesenteric ischemia exclusively, 1 case showed no obviously bowel wall thickening or thinner, 2 cases showed bowel wall thickening and thinner simultaneously. On contrast-enhanced CT, 11 cases showed target appearance; 3 cases showed enhanced or normal and 10 cases showed luminal dilation in reversible mesenteric ischemic. The bowel walls were no or diminished enhanced in 7 cases, and 2 cases showed luminal dilation in irreversible mesenteric ischemia. 22 cases were revealed with mesenteric edema and 4 cases with ascites and 9 cases with pneumatosis. The etiology was confirmed in all of the 30 cases. Conclusion The bowel wall usually became thinner in irreversible mesenteric ischemia cases caused by stenosis or occlusion of SMA/IMA, while thicker in reversible mesenteric ischemic cases. Intestinal ischemia can be diagnosed accurately by MSCT in most cases, and it is of great value to determine the extent and etiology of intestinal ischemia.

关 键 词：缺血性肠病 多层螺旋CT 肠壁增厚 肠腔积液 

分 类 号：TH774[机械工程—仪器科学与技术]