多层螺旋CT口服法小肠造影对小肠病变的诊断价值  

Diagnostic value of Multislice computed tomography enterography in small bowel diseases

作　　者：朱勇华 管雪静 ZHU Yong-hua;GUAN Xue-jing(Department of Radiology, Qujing First People's Hospital, Qujing 655000, China)

机构地区：[1]曲靖市第一人民医院放射科,云南曲靖655000

出　　处：《中国医药指南》2019年第5期6-7,9,共3页Guide of China Medicine

摘　　要：目的探讨多层螺旋CT口服法小肠造影(MSCTE)检查对小肠病变的应用价值。方法回顾性分析100例确诊为小肠病变的CTE影像资料,评估患者肠壁异常增厚,肠壁分层(靶征),肠黏膜异常强化,肠腔狭窄,木梳征、肠系膜淋巴结大小和数量及肠外并发症如瘘道、溃疡、脓肿等情况,并进行CTE综合评价。结果 100例患者中未发现异常10例,小肠肿瘤40例,小肠间质瘤20例,其中良性15例、恶性5例,十二指肠腺瘤5例,回肠淋巴瘤10例,回肠系膜淋巴管瘤2例,卵巢癌小肠转移1例,回盲部黏液癌1例,乙状结肠癌并穿孔、脓肿、溃疡1例;炎症性病变或小肠其他病变50例,克隆恩病(CD)16例,溃疡性结肠炎(UC)10例,回肠及肠系膜结核10例,十二指肠球部植物性粪石5例,2例肠系膜上静脉血栓并小肠缺血坏死,7例回肠憩室并脓肿形成。100例患者中外科手术、内镜检查或穿刺活检90例,10例影像检查患者为内镜检查并随访以上证实。结论多层螺旋CT口服法小肠造影检查是诊断小肠病变的重要手段,有着高度的准确性,此项检查提供内镜所不能提供的优势,包括观察黏膜等全层肠壁的结构和肠外并发症病变,也可透过近端肠腔扩张的表现以提示肠道狭窄的部位。Objective Evaluate the value of Multislice computed tomography enterography(MSCTE) in the diagnosis of small bowel diseases.Methods Analyze CTE images of 100 cases with small bowel diseases were retrospectively, assess patients with abnormal bowel wall thickening, Intestinalstratification(target sign), abnormal enhancement of intestinal mucosa, intestinal stenosis, increased mesenteric vascular bundle, the size and numberof mesenteric lymph nodes and parenteral complications such as fistula, abscess, ulcer etc. Meanwhile, CTE comprehensive evaluation. Results 100 cases were not found abnormal in 10 cases, intestinal tumor in 40 cases, small intestinal stromal tumor in 20 cases(15 cases were benign, and the other5 was malignant), duodenal adenoma in 5 cases, ileal lymphoma in 10 cases, ileal lymphangioma in 2 cases, small bowel metastasis of ovarian cancer in1 cases, ileocecal mucinous carcinoma 1 cases, sigmoid colon cancer with perforation, abscess and ulcer in 1 cases, inflammatory lesions or other smallbowel lesions in 50 cases, crohn disease(CD) in 16 cases, ulcerative colitis(UC) in 10 cases, ileum and mesenteric tuberculosis in 10 cases, duodenalvegetal phytobezoar in 5 cases, 2 cases of superior mesenteric venous thrombosis with small intestinal necrosis, 7 cases of ileal diverticulum and abscessformation. 100 cases were treated with surgery, endoscopy or puncture biopsy in 90 cases, 10 patients were followed up by endoscopy and confirmed.Conclusion Multi slice spiral CT oral small bowel radiography is an important method for diagnosis of small bowel diseases, it has a high degree ofaccuracy, this examination provides the advantage that endoscopy cannot provide, It includes the observation of the structure of the intestinal mucosaand the pathological changes of the intestinal tract, it can also be used to indicate the location of intestinal stenosis through the expression of proximalintestinal lumen.

关 键 词：多层螺旋CT 小肠病变 对比剂 增强扫描 计算机体层摄影 

分 类 号：R445.3[医药卫生—影像医学与核医学] R574[医药卫生—诊断学]