成人Henoch紫癜的螺旋CT诊断  

Spiral CT Features of Henoch Purpura in Adult Patients

作　　者：梁志文 许美 张戟风[3] 刘景旺[4] 

机构地区：[1]秦皇岛市骨科医院影像科,066000 [2]唐山市强制隔离戒毒所 [3]沧州医学高等专科学校 [4]华北理工大学附属开滦总医院影像科

出　　处：《临床放射学杂志》2017年第5期697-700,共4页Journal of Clinical Radiology

摘　　要：目的探讨总结成人Henoch紫癜的螺旋CT影像特点。方法回顾性分析20例Henoch紫癜患者螺旋CT表现,对肠壁病变范围、肠壁形态、肠管外脂肪间隙及肠系膜改变、肠腔内外伴发征象、强化表现及腹腔积液情况等分析总结。结果 20例Henoch紫癜患者中,单一部位受累11例,多部位受累9例。胃受累3例,十二指肠受累6例,空、回肠受累13例,结肠受累8例。18例病变肠管管壁弥漫增厚,其中10例肠壁环形增厚,解剖层次清晰;8例增厚肠壁解剖层次模糊。15例浆膜外肠系膜侧脂肪间隙密度增高。3例腹腔少量积液。10例行CT增强扫描患者中,8例显示肠壁全层弥漫强化;2例肠壁分层强化。3例结肠肠腔内积血。肠管3~7天肿胀减轻8例;肠管7~14天基本恢复正常17例;3例1个月后恢复。结果 Henoch紫癜的基本CT征象包括弥漫或多节段肠管均匀全层或环形分层增厚,弥漫全层或环形强化及浆膜外渗出。CT检查是Henoch紫癜诊断和复查的有效手段。Objective To investigate the spiral CT radiological features of Henoch purpura. Methods Spiral CT data of 20 patients with Henoch purpura were retrospectively analyzed. The intestinal range, morphology, fat clearance of periintestinal area, enhanced performance and seroperitoneum were studied. Results In all patients＇ pretreatment, involvemerit of a single part was found in 11 cases （55.0%） and muhisegmental involvement was seen in 9 cases （45.0%）. The duodenum, jejunum and colon were involved in 6, 13, 8 patients respectively, and the stomach in 3 patients. 18 patients （90.0%） were found suffuse thickening of the intestinal wall. There were 8 cases which were uniform and 10 cases with annular layer thickening of the intestinal wall. 15 cases （75.0%） had serosal membrane effusion. In 10 contrast enhanced patients, the diseased bowel wall showed 8 cases with uniform thickening and 2 cases with ＂double loop＂ sign thickening. There were 3 cases hematocele in the colon. Of 20 patients, 8 patients improved in 3 -7 days and 17 patients （85.0%） had convalesced in 7 - 14 days. Conclusion Spiral CT characteristics of Henoch purpura were multisegmental parts, uniform full-thickness or annular layer thickening of the intestinal wall, full-thickness or annular contrast enhanced and serosal membrane effusion. CT examination can effectively diagnosis and follow up treatment response.

关 键 词：腹型紫癜 过敏性 体层摄影术 X线计算机 

分 类 号：R554.6[医药卫生—血液循环系统疾病]