闭孔疝继发小肠梗阻的MSCT表现  

MSCT Features of Obturator Hernia Causing Small Bowel Obstruction

作　　者：王璐[1] 旷连勤[1] 程诚[1] 邓晓娟[1] 李然[1] 王毅[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所放射科,重庆400042

出　　处：《临床放射学杂志》2016年第2期227-231,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81071145)

摘　　要：目的探讨闭孔疝继发小肠梗阻的MSCT表现特征。方法回顾性分析经手术证实的16例闭孔疝继发小肠梗阻患者的临床及影像学资料。其中男1例,女15例;年龄74~91岁,平均83.5岁。16例均行腹部平片、MSCT平扫及动态增强扫描,其中9例行胃肠道造影检查。结果 MSCT对全部闭孔疝和继发性小肠梗阻均做出准确诊断而腹部平片和胃肠道造影均未能做出闭孔疝的诊断。16例闭孔疝位于右侧11例(68.8%),左侧5例(31.3%)。疝内容物均为回肠并继发低位小肠梗阻,梗阻程度表现为轻度3例(18.8%),中度7例(43.8%)重度6例(37.5%)。疝囊形态表现为类圆形9例(56.3%),泪珠状5例(31.3%),短管状2例(12.5%)。疝囊最大径2.00~3.20 cm,平均(2.469±0.352)cm;疝囊体积2.02~9.77 cm^3,平均(4.517±2.441)cm^3。结论闭孔疝继发小肠梗阻具有特征性MSCT表现,MSCT曲面重组可充分展现疝囊与继发性小肠梗阻之间的解剖关系,能为治疗计划的制定提供有用的影像学信息。Objective To explore the multi- slice spiral CT(MSCT) features of an obturator hernia causing small bowel obstruction.Methods Clinical and imaging data of 16 patients with obturator hernia and secondary small bowel obstruction proven by operation were analyzed retrospectively.All patients had an abdominal radiograph,MSCT plain and dynamic contrast- enhanced scan done;in which 9 patients had a gastrointestinal contrast examination done.Results All 16 obturator hernias with small bowel obstruction were correctly diagnosed by MSCT,but no hernia was diagnosed by abdominal radiograph or gastrointestinal contrast examination.The locations of these hernias were found to be more frequently on the right side(11 cases,68.8%) than on the left side(5 cases,31.3%).The hernia contents were all ileal loops and following low small bowel obstruction which was graded as mild(3 cases,18.8%),moderate(7 cases,43.8%) and severe(6 cases,37.5%).The hernial sac ranged from 2.00 to 3.20 cm(mean,2.469 ± 0.352 cm) in maximum dimension and 2.02 to 9.77 cm^3(mean,4.517 ± 2.441 cm^3) in volume,and its shapes were classified as ovoid(9 cases,56.3%),teardrop contour(5 cases,31.3%) and short tubular(2 cases,12.5%).Conclusion Obturator hernia causing small bowel obstruction has characteristic MSCT features.MSCT curved planar reformation can reveal the anatomical relationship between the hernial sac and the secondary small bowel obstruction,which is useful to make an appropriate clinical treatment planning.

关 键 词：闭孔疝 小肠梗阻 体层摄影术 X线计算机 曲面重组 多平面重组 

分 类 号：R656.2[医药卫生—外科学] R816.5[医药卫生—临床医学]