麦克尔憩室及并发症的MSCT表现  

Multislice spiral CT findings of Meckel′s diverticulum and its complications

作　　者：陈颖[1] 唐永华[2] 胡春洪[3] 陈双庆[1] CHEN Ying;TANG Yong-hua;HU Chun-hong(The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou Municipal Hospital,Jiangsu 215001,China)

机构地区：[1]南京医科大学附属苏州医院,苏州市立医院,江苏215001 [2]上海交通大学附属瑞金医院,上海200025 [3]苏州大学附属第一医院,江苏215006

出　　处：《放射学实践》2021年第7期889-893,共5页Radiologic Practice

摘　　要：目的:探讨麦克尔憩室及并发症的多层螺旋CT(MSCT)表现,提高对该病的诊断水平。方法:回顾性分析64例经手术病理证实的麦克尔憩室及其并发症的MSCT表现,包括憩室的位置、大小、憩室壁厚度、强化、供血动脉等,并与病理结果进行对照分析。结果:64例中MSCT检出麦克尔憩室56例(87.5%)。56例中,最常见部位是右下腹(62.5%),其次是中下腹(19.6%)。憩室位于肠管肠系膜游离缘25例(44.6%),憩室末端指向脐孔11例(19.6%),存在软组织结节11例(19.6%),存在独立供血动脉20例(35.7%)。独立供血动脉与憩室强化程度存在相关性(P<0.05)。消化道出血41例,40例(97.6%)未能在MSCT中发现出血征象。急性憩室炎5例,表现为憩室壁增厚、强化,周围渗出,1例伴穿孔,见腹腔游离气体。肠梗阻8例,6例为粘连性肠梗阻。憩室内翻4例,2例表现为肠腔内明显强化的实性肿块,2例导致肠套叠。MSCT检出的56例憩室中,15例(26.8%)存在异位组织。异位组织与憩室壁结节及强化程度存在相关性(P<0.05)。结论:麦克尔憩室及并发症的MSCT表现具有一定特点,掌握其CT表现有助于提高术前诊断水平。Objective:To investigate MSCT findings of Meckel′s diverticulum(MD)and its complications to improve the diagnostic capability of this disease.Methods:MSCT features of 64 patients with MD confirmed by surgery and pathology were retrospectively analyzed.The following features of MD including location,size,diverticular wall thickness,enhancement and the feeding artery were recorded.Results:In all patients,56(87.5%)cases with MD have been detected in MSCT.The most common location of MD was at the right lower abdomen(62.5%)and midline lower abdomen(19.6%),respectively.Twenty-five cases(44.6%)with MD were located at the antimesenteric border of distal ileum and 11 cases(19.6%)were pointed to the umbilicus.Soft tissue nodule was detected in the wall of diverticulum in 11 cases(19.6%)and independent feeding artery was seen in 20 cases(35.7%).The independent feeding artery was related to the enhancement degree of MD(P<0.05).Of 41 patients with gastrointestinal bleeding,40 cases(97.6%)were failed to find positive signs of bleeding in MSCT.In 5 cases with acute diverticulitis,the thicken wall with enhancement of diverticulum and mesenteric inflammatory changes were observed.Intraperitoneal free gas was detected in one case with gastrointestinal perforation.Of 8 patients with intestinal obstruction,6 cases were caused by intestinal adhesion.Of 4 inverted diverticula,2 cases were manifested as intraluminal enhanced masses in MSCT,and the other 2 cases resulted in intussusception.Of 56 cases with MD detected in MSCT,ectopic tissues were pathologically detected in 15 cases(26.8%).Ectopic tissue was related to the mural nodule and the enhancement degree of MD(P<0.05).Conclusion:MSCT findings of MD and its complications have certain characteristic findings,which can aid in improving the preoperative diagnostic capability.

关 键 词：麦克尔憩室 诊断 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R57[医药卫生—放射医学]