CT在机械性肠梗阻诊断中的作用  

Value of CT in the diagnosis of mechanical intestinal obstruction

作　　者：明兵[1] 李振勋[1] 高源统[1] 汪永桢[1] 王晓阳[1] 蒲青凡[2] 余瑞立[2] 

机构地区：[1]温州医学院附属第三医院(瑞安市人民医院)放射科,瑞安325200 [2]温州医学院附属第三医院(瑞安市人民医院)普外科,瑞安325200

出　　处：《中华放射学杂志》2002年第10期896-900,共5页Chinese Journal of Radiology

摘　　要：目的　探讨CT对临床或 (和 )X线平片疑为肠梗阻疾病的诊断价值。方法　回顾性分析临床或 (和 )X线平片疑为肠梗阻疾病的 52例患者的平扫及增强CT检查表现 ,并与手术病理结果比较。结果　 52例手术治疗患者中 ,48例 (92 % )手术结果与CT表现相符 ,包括肠肿瘤 1 2例 ,肠粘连1 0例 ,肠套叠 9例 (含 5例肿瘤 ) ,肠扭转及腹外疝各 5例 ,胆石 3例 ,回盲部感染 3例 ,Crohn病 1例。肠肿瘤和肠粘连各误诊 2例 ;5例肠壁缺血 (提示肠绞窄 ) 4例CT诊断明确 ,主要表现为肠壁增厚及肠壁强化减弱。结论　CT能区分机械性肠梗阻和其他原因引起的肠管扩张 ,快速显示梗阻的部位和病因 ,提示肠绞窄 ,有助于临床及时制定正确的治疗方案 ,因此 。Objective To evaluate the role of CT in the diagnosis of patients with suspected intestinal obstruction in whom clinical and/or plain radiographic findings were inconclusive. Methods The plane and contrast enhanced CT manifestation and surgical findings or clinical follow up in 52 cases with mechanical intestinal obstruction were retrospectively analyzed. Results CT manifestation and surgical findings were consistent in 48 (92%) of 52 cases,including primary or secondary neoplasms (12), adhesions (10), intussusception (9, including 5 cases of neoplasms),bowel torsion (5), external or internal hernias (5), gallstone ileus (3),appendicitis (2), Crohn′s disease (1), and colon ulcer (1). Neoplasms and adhesions was misdiagnosed in 2 cases each.A CT diagnosis of ischemia was made in 4 of 5 patients,the most frequent CT findings were reduced enhancement of the bowel wall and thickening of the bowel wall. Conclusion CT can help differentiate mechanical obstruction from other conditions resulting in bowel dilatation,determine the location and cause of obstruction rapidly, and reveal the evidence of strangulation.These make CT particularly valuable in the management of intestinal obstruction.

关 键 词：肠梗阻 CT 评价研究 诊断 

分 类 号：R816.5[医药卫生—放射医学]