多排螺旋CT血管成像结合低张小肠造影对小肠出血性疾病的诊断价值  

Effectiveness of combination of application of multi-slice spiral CT angiography and hypotonic enterography in diagnosis of small intestinal hemorrhagic disease

作　　者：胡海菁[1] 彭荣华 高峰 徐新超 HU Hai-jing;PENG Rong-hua;GAO Feng;XU Xin-chao(Department of Radiology,Nanhai District People＇s Hospital of Foshan City,Guangdong Province,Foshan 528200,China;Department of Radiology,Nanhai District Guicheng Hospital of Foshan City,Guangdong Province,Foshan528200,China)

机构地区：[1]广东省佛山市南海区人民医院放射科,广东佛山528200 [2]广东省佛山市南海区桂城医院放射科,广东佛山528200

出　　处：《中国当代医药》2018年第24期106-108,114,共4页China Modern Medicine

基　　金：广东省佛山市医学类科技计划项目(2016AB000632)

摘　　要：目的研究多排螺旋CT血管成像(MSCTA)与低张小肠造影联合诊断小肠出血性疾病的应用价值。方法回顾性分析2016年8月~2017年8月广东省佛山市南海区人民医院收治的拟诊小肠出血疾病患者45例,采用MSCTA结合低张小肠造影方法进行检查。扫描前患者均口服等渗甘露醇、肌注山莨菪碱(654-2)在肠腔充分充盈的基础上,联合多排螺旋CT小肠血管成像,分析45例患者造影效果及检出率。结果患者十二指肠、空肠,回肠及回盲部充盈良好,肠腔内为低密度等渗液体,肠腔、肠壁及肠周围脂肪对比清晰,肠系膜血管基本可显示到3级或以上。手术与内镜活检病理发现病变32例。CT病变检出率为86.1%(31/36),与病理相符率87.5%(28/32)。结论多排螺旋CT血管成像(MSCTA)结合低张小肠造影对小肠出血性疾病的诊断效果较好,对指导临床治疗方案的选择、评价手术效果、估计预后有重要意义,具有较高的临床应用和推广价值。Objective To study the effectiveness of combination of application of multi-slice spiral CT angiography（MSCTA） and hypotonic enterography in diagnosis of small intestinal hemorrhagic diseases. Methods Altogether 45 cases of clinically suspected small intestinal hemorrhagic diseases who were hospitalized in Nanhai District People′ s Hospital of Foshan, from August 2016 to August 2017 were retrospectively analyzed and examined by using MSCTA combined with hypotonic enterography. Before scanning, all the patients orally took isosotic mannitol and intramuscular anisodamine（654-2） on the basis of full filling of the intestinal cavity and then underwent multi slice spiral CT small intestinal angiography. The contrast effect and detection rate of 45 cases were analyzed. Results The duodenum, jejunum, ileum and ileocecal filling were good, with low density isosotic liquid in the intestinal cavity; the fat in the intestinal cavity, intestinal wall and the surrounding intestine were clear, and the mesenteric vessels could be shown to the level of 3 or above. Pathological changes were found by the surgery and endoscopic biopsy in 32 cases. The lesion detection rate by using CT was 86.1%（31/36）, and the coincidence rate was 87.5%（28/32） in contrast with pathology.Conclusion Application of combination of multi slice spiral CT angiography（MSCTA） and hypotonic enterography has a good effect in the diagnosis of small intestinal hemorrhagic diseases. It is of great significance in guidance of the selection of clinical treatment scheme, evaluation of the surgical effect and estimation of the prognosis, which has high clinical application and popularization value.

关 键 词：CT 血管成像 低张小肠造影 小肠出血性疾病 诊断 

分 类 号：R816.5[医药卫生—放射医学]