儿童腹部钝性损伤致十二指肠肠壁血肿CT和MRI表现  

The CT and MRI findings of intramural hematoma duodenum in children with blunt abdominal trauma

作　　者：李钱程 张欣贤 郝向东 李成龙 张龚巍[2] 

机构地区：[1]江苏省徐州市儿童医院放射科,江苏徐州221000 [2]广东省深圳市儿童医院放射科,广东深圳518026

出　　处：《医学影像学杂志》2017年第11期2171-2175,共5页Journal of Medical Imaging

摘　　要：目的探讨儿童腹部钝性损伤十二指肠致肠壁血肿CT和MRI特征。方法回顾性分析经手术或临床证实的8例十二指肠壁血肿CT和MRI资料。结果病灶均单发,肠腔内7例,肠腔外1例,呈管状型或类圆形,边缘清楚6例,模糊2例,位于单一肠段4例,多个肠段4例。CT扫描病灶呈等高密度包块,密度不均匀,典型者可见"融冰征"和(或)"空气裂隙征";MRI扫描病灶T1WI呈稍高或混杂信号,T2WI呈低或等高信号,增强扫描病灶内均无强化,其中血肿壁强化3例。结论儿童腹部钝性损伤致十二指肠肠壁血肿影像学表现特殊,CT、MRI平扫及增强扫描检查对病灶的显示具有优越性,有助于肠壁血肿的早期诊断和治疗。Objective To study the CT and MRI features of intramural hematoma duodenum in children with blunt abdominal trauma. Methods The findings of CT and MRI in 8 cases of intramural hematoma duodenum which had been confirmed by sur- gery or clinical treatment were retrospectively analyzed. Results All the lesions were single, 7 cases in the intestinal lumen, and the other one in the external intestinal lumen, which were tubular type or quasi-circular, with clear margins in 6 cases and vague in 2 cases. There were 4 cases in a single intestinal segment and 4 cases in multiple intestinal segment. CT scan showed a high density of the lesions, and the density was not uniform, and typical ＂Melting-ice ＂and/or ＂air fissure＂ features can be seen. MRI scan suggested slight increase or mixed T1WI signal, and low or uniform high T2 WI signal, and enhanced scan suggested no en- hancement in lesions, but enhancement in the hematoncus intestinal wall was observed in three cases. Conclusion The imaging findings of intramural hematoma duodenum in children with blunt abdominal trauma are special, CT and MRI scan and contrast enhancement scanning will contribute to the early diagnosis and treatment of the intramural hematoma.

关 键 词：钝性损伤 肠壁血肿 体层摄影术 X线计算机 磁共振成像 

分 类 号：R656.6[医药卫生—外科学]