新生儿急腹症的低剂量MSCT表现  

MSCT features of acute abdomen in neonates

作　　者：郑楠楠[1] 闫学强[2] 杨豪 邵剑波[1] 马慧静[1] 周婧 ZHENG Nan-nan;YAN Xue-qiang;YANG Hao(Imaging Center,Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huangzhong University of Science and Technology,Wuhan 430015,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)影像中心,武汉430016 [2]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)普外科,武汉430016

出　　处：《放射学实践》2019年第8期911-915,共5页Radiologic Practice

摘　　要：目的:探讨新生儿急腹症的低剂量MSCT表现及鉴别诊断要点。方法:回顾性分析2016年10月-2017年12月本院201例经临床证实的急腹症患儿的影像资料。所有患儿在术前使用GEOptimaCT660螺旋CT机进行全腹部CT平扫。对原始图像采用0.625mm层厚进行重建,使用多平面重组(MPR)、最大密度投影(MIP)等技术对图像进行后处理。结果:201例中先天性小肠闭锁45例,其中十二指肠闭锁4例,主要MSCT表现为“双泡征”;空回肠闭锁41例,主要征象包括小肠梗阻和细小结肠征;先天性肠旋转不良41例,表现为“中心点征”26例,“漩涡征”6例;坏死性小肠结肠炎30例,主要表现为肠壁小囊状或串珠状透亮影12例,细线状、半弧状及环状透亮影27例,两种形式共同存在9例;胎粪性腹膜炎13例,均可见腹腔内肠腔外钙化灶;肛门直肠畸形80例,其中Currarino综合征7例。结论:MSCT图像可明确诊断新生儿急腹症的病因及并发症,同时可了解腹壁、腹膜腔和肠壁情况,可为临床提供有价值的诊断信息。Objective:The aim of this study was to explore the manifestations and differential diagnosis of neonatal acute abdomen on low-dose MSCT.Methods:The imaging data of 201 neonates from October 2016 to December 2017 with acute abdomen confirmed by clinical diagnosis were analyzed retrospectively.All patients underwent whole abdomen low-dose MSCT scan before surgery using a GE Optima CT660 scanner.The images of 0.625mm thickness were reconstructed using adaptive statistical iterative reconstruction(ASIR)technique.Multi-planar reformation(MPR)and maximum intensity projection(MIP)technique were used for image post-processing.Results:Of the 201 cases,there was 45 cases with congenital small intestinal atresia presented"double vesicles"sign,including 4 duodenal atresia;41 cases with jejuno-ileal atresia showed small intestinal obstruction and"small colon sign";41 cases with congenital malrotation of intestine showed"central point sign"in 26 cases and"whirlpool sign"in 6 cases.There were 30 cases with necrotizing enterocolitis.MSCT showed 12 cases with small cystic or beaded translucent shadow of intestinal wall,27 cases with thin linear,semi-arc and circular translucent shadow,and 9 cases with the two features coexisted.13 cases of meconium peritonitis,intra-abdominal extraintestinal calcification were found.There were 80 cases with anorectal malformation including 7 Currarino syndrome.Conclusion:Low-dose MSCT can display the etiology and complications of neonatal acute abdomen.It can clearly show the details of abdominal wall,peritoneal cavity and intestinal wall,which provides more valuable data for diagnosis.

关 键 词：急腹症 新生儿 体层摄影术 X线计算机 诊断 

分 类 号：R814.42[医药卫生—影像医学与核医学] R722.19[医药卫生—放射医学]