肠缺血病变的MSCT诊断  

The Diagnositic Value of MSCT on Bowel Ischemia

作　　者：王保海[1] 孙静涛[2] 李倩[2] 王来友[2] 王东平 刘晓军[4] 周小森[1] 

机构地区：[1]遵化市人民医院CT室,河北遵化064200 [2]唐山市妇幼保健院妇儿医院放射科,河北唐山063000 [3]遵化市第二医院CT室,河北遵化064200 [4]唐山市第三医院放射科,河北唐山063000

出　　处：《CT理论与应用研究（中英文）》2017年第1期77-84,共8页Computerized Tomography Theory and Applications

基　　金：河北省2016年度医学科学研究重点课题计划(20160910)

摘　　要：目的:探讨肠缺血病变的MSCT表现及对其诊断价值,为临床治疗提供帮助。资料和方法:回顾性分析经DSA、手术、病理或临床最终确诊证实的55例肠缺血性病变患者行MSCT平扫及增强检查资料,对病变的部位、范围、病变段肠管的强化程度、相关的肠道外征象以及CTA进行诊断分析。结果:55例中,肠系膜上动脉栓塞或血栓形成13例,肠系膜上静脉血栓形成22例,缺血性结肠炎2例,肠扭转6例,粘连性肠梗阻5例,肠套叠4例及腹内疝3例。MSCT及CTA表现:肠腔扩张积液41例,肠系膜水肿33例(缆绳征5例、脂肪浑浊征27例,积气1例),肠系膜血管走行异常17例(漩涡征5例,位置异常10例)及血管充盈缺损或狭窄35例。结论:MSCT对肠缺血病变显示敏感性高,且表现具有一定特征性,应作为常规和首选,同时密切结合临床,不仅对肠缺血病变能做出正确诊断,而且在查找病因、鉴别诊断等方面都有重要作用,为临床精准治疗提供依据。Objective： To explore the finding and diagnostic value of MSCT in intestinal ischemia disease and provide help for clinical treatment. Methods： Retrospective analysis the MSCT plain and enhanced performance of intestinal ischemic lesions in 55 cases were final diagnosed by DSA, surgery, pathology or clinical. Results： Of the 55 patients, there were superior mesenteric artery embolism or thrombosis in 13 cases, mesenterie venous thrombosis in22 cases, ischemic colitis in 2 cases, volvulus in 6 cases, intestinal obstruction in 5 cases, intussusceptions in 4 cases, internal abdominal hernias in 3 cases. The MSCT and CTA findings of the 55 patients, there were lumen expansion and effusion in41 cases, mesenteric edema in 33 cases （cable levy in 5 cases, tat muddy levy in 27 cases, product gas in lease）, mesenteric vascular abnormalities take shape in 17 cases （there were whirlpool sign in 5 cases, abnormal position in 10 cases）, vascular stenosis or filling defect in35 cases. Conclusion： MSCT findings of intestinal ischemia lesions has high sensitivity and certain characteristic, it should be as routine and preferred examination, at the same time refer to clinical manifestations, we can make the correct diagnosis and provide the basis for accurate clinical treatment for the important action of the etiologies and differential diagnosis.

关 键 词：肠缺血 体层摄影术 X线计算机 

分 类 号：R574[医药卫生—消化系统] R816.5[医药卫生—内科学]