多层螺旋CT血管成像及后处理技术对成人中肠旋转不良的诊断价值  

The diagnostic value of MDCT angiography and post treatment for malrotation of midgut in adults

作　　者：刘文冬[1] 刘斌[1] 巢惠民 王菁 王斌[3] 朱坤[1] LIU Wendong;LIU Bin;CHAO Huimin;WANG Jing;WANG Bin;ZHU Kun(Department of Radiology,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230032,China;Department of Radiology,Binhu Hospital,Hefei,Anhui 230041,China;Department of Epidemiology and Biostatistics,School of Public Health,Anhui Medical University,Hefei,Anhui 230031,China)

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230032 [2]滨湖医院放射科,安徽合肥230041 [3]安徽医科大学公共卫生学院,安徽合肥230031

出　　处：《安徽医药》2020年第4期739-742,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨多层螺旋CT(MDCT)血管造影及后处理技术对中肠旋转不良的诊断价值。方法选择安徽医科大学第一附属医院2016年6月至2019年1月3年期间13例经临床手术确诊中肠旋转不良的病人,回顾性分析MDCT影像图像及临床资料。结果11例出现“漩涡征”,阳性率为85%;3例出现肠系膜动静脉位置“换位征”,阳性率仅为23%,;10例空肠动脉呈180°翻转,血管位于腹腔右侧,阳性率高达77%;7例空肠位于右上腹腔,回肠位于左中下腹腔;5例空肠位于右上腹腔,回肠位于右下腹腔;2例回盲部及阑尾位置出现异常,阳性率仅为15%,1例位于左下腹,1例位于右中腹;3例出现游离横结肠征象,阳性率为23%。结论MDCT血管造影及后处理技术对诊断中肠旋转不良具有较高的诊断价值,特别是肠系膜“漩涡征”及空肠动脉“翻转征”具有一定的特异性。Objective To evaluate the value of multislice spiral CT angiography and post treatment in the diagnosis of malrotation of midgut.Methods A total of 13 patients with malrotation of midgut diagnosed by clinical surgery in The First Affiliated Hospital of Anhui Medical University from June 2016 to January 2019 were selected,and the CT images and clinical data were retrospective ly analyzed.Results Eleven cases presented vortex sign,with a positive rate of 85%.Three cases presented“transposition sign”of the arteriovenous position of mesentery,the positive rate being only 23%.In 10 cases,the jejunal artery was 180°flipped,and the blood vessel was located in the right side of the abdominal cavity,with a positive rate of 77%.The jejunum was located in the right upper abdominal cavity and ileum in the left lower and middle abdominal cavity in 7 cases.The jejunum was located in the right up per abdominal cavity and ileum in the right lower abdominal cavity in 5 cases.Abnormal position of ileocecum and appendix was found in 2 cases,the positive rate being only 15%,of which abnormality was located in the left lower abdomen in 1 case and the right middle abdomen in the other one.Free transverse colon was found in 3 patients,with a positive rate of 23%.Conclusions MDCT angiography and post treatment have high value in the diagnosis of malrotation of the midgut,and the mesenteric vortex sign and jejunal artery flip sign have especially certain specificity.

关 键 词：肠/畸形 胚胎发育 内脏异位综合征 体层摄影术 X线计算机 成年人 中肠 旋转不良 

分 类 号：R816.5[医药卫生—放射医学]