蛋白丢失性肠病的多层螺旋CT小肠造影特征  

The characteristics of MSCT enterography in patients with protein-losing enteropathy

作　　者：李从海 薛华丹[2] 孙才渊 赵双全[1] 周永生[1] 刘炜[2] 刘婧娟[2] 潘卫东[2] 金征宇[2] LI Conghai;XUE Huadan;SUN Cai yuan;ZHAO Shuangquan;ZHOU Yongsheng;LIU Wei;LIU Lingjuan;PAN Weidong;JIN Zhengyu(Department of Radiology ,the People's Hospital of Bao'an , Shenzhen 518109 ,China;Department of Radiology , Peking Union Medical College Hospital,Chinese Academy of Medical Sciences , Beijing 100730 ,China;Department of Radiology ,Shenzhen Sun Yat-sen Cardiovascular Disease Hospital,Shenzhen 518003 ,China)

机构地区：[1]深圳市宝安区人民医院放射科,广东深圳518109 [2]中国医学科学院北京协和医院放射科,北京100730 [3]深圳市孙逸仙心血管病医院放射科,广东深圳518003

出　　处：《实用放射学杂志》2019年第8期1266-1270,共5页Journal of Practical Radiology

基　　金：深圳市宝安区医疗卫生基础研究项目(2017JD123)。

摘　　要：目的探讨蛋白丢失性肠病(PLE)的MSCT小肠造影特征性表现。方法回顾性分析41例确诊PLE并行MSCT小肠造影检查患者的临床资料和CT图像。重点观察胃、肠管、肠系膜血管的异常MSCT表现。同时也观察胸、腹水、腹部其他脏器等异常。结果 41例中胃壁增厚3例;空肠肠壁增厚34例,均未见肠管扩张;回、结肠壁局限或多发管壁增厚分别为18例和8例;回、结肠节段性或弥漫性扩张分别为8例和4例。增强后,增厚胃壁轻至中度强化;增厚空肠肠壁轻度强化12例;回、结肠壁强化分别为11例和4例,其中回肠黏膜面强化4例;腹盆腔多发囊性低密度灶及升结肠广泛肿块样改变各1例;门静脉血栓、门静脉广泛侧支循环形成、脾静脉闭塞、肠系膜上静脉迂曲、分流等征象单独或合并存在者共8例;小肠-结肠瘘3例;肠系膜淋巴结增多、饱满15例;肠系膜水肿6例;胸、腹腔及心包积液共12例;胸腹壁皮下水肿11例。结论 PLE MSCT小肠造影重组主要表现为:(1)空肠壁全层增厚,空肠肠管扩张受限,增强后轻度强化或不强化,黏膜面不强化;(2)病变多数累及范围广泛,累及回肠、结肠,肠壁可增厚,肠管扩张及黏膜面强化;(3)门静脉系统慢性狭窄;(4)肠道本身病变所致PLE患者,同时具有基础病变特征。Objective To investigate the characteristic features of MSCT enterography in patients with protein-losing enteropathy (PLE).Methods Clinical data and MSCT enterography images of 41 patients diagnosed as PLE were analyzed retrospectively.The abnormal MSCT manifestations of the stomach,bowel and mesenteric vessel were observed emphatically.At the same time,the abnormalities of the chest,ascites and other abdominal organs were also observed.Results In the 41 patients,gastric wall thickening was found in 3 patients.Jejunal wall thickening without bowel dilatation was observed in 34 patients.Local or diffuse thickening of ileal wall and multiple thickening of colon wall were observed in 18 and 8 patients, respectively. Segmental or diffuse dilation of ileum and colon were found in 8 and 4 patients, respectively. The contrast-enhanced abnormalities were as follows: the mildly to moderately enhanced and thickened gastric wall,the slightly enhanced and thickened jejunal wall in 12 patients,and enhanced ileal wall and colonal wall were observed in 11 and 4 patients, respectively, including 4 patients with ileal mucosa enhancement. There was 1 patient with multiple cystic low-density lesions in abdominal and pelvic cavity and 1 patient with extensive tumor-like changes in the ascending colon.Portal vein thrombosis, extensive collateral circulation formation of portal vein,occlusion of splenic vein and tortuous or redistribution of superior mesenteric vein were individually or concurrently presented in 8 patients.Small intestinal-colon fistula was found in 3 patients.Mesenteric lymph nodes were enlarged in 15 patients.Mesenteric edema occurred in 6 patients. Hydrothorax, ascites and hydropericardium occurred in 12 patients.Subcutaneous edema of thoracic and abdominal wall was found in 11 patients. Conclusion The characteristic features of MSCT enterography in patients with PLE include the thickened whole layer of the jejunal wall and dilation-restricted the jejunum with mild or non enhancement and without enhanced mucosal s

关 键 词：蛋白丢失性肠病 计算机体层成像 

分 类 号：R574[医药卫生—消化系统] R814.42[医药卫生—内科学]