成人梅克尔憩室及并发症的MSCT表现及分析  

Analysis of multi-slice CT findings of Meckel′s diverticulum and its complications in adults

作　　者：陈庆航 张繁 唐广磊 黄训波 张流柳 傅建斌 庞统亮 关键[2] CHENQing-hang;ZHANG Fan;TANG Guang-lei(Department of Radiology,the Wuzhou Hospital of Traditional Chinese Medicine,Guangxi 543002,China;不详)

机构地区：[1]梧州市中医医院放射科,广西梧州543002 [2]中山大学附属第一医院影像科,广东广州510080 [3]潮州市人民医院CT室,广东潮州521000 [4]吉安市第一人民医院放射科,江西吉安343000

出　　处：《放射学实践》2023年第4期474-479,共6页Radiologic Practice

基　　金：梧州市科技计划项目(201902204)。

摘　　要：目的:探讨成人梅克尔憩室(MD)及其并发症的MSCT表现,提高对该病的诊断水平。方法:回顾性分析2014年6月-2022年12月共13例成人MD患者的临床及MSCT资料。所有患者行平扫和对比增强MSCT扫描,3例行核素扫描。全部病例经临床诊断和手术病理证实。结果:本组中男12例、女1例,年龄26~79岁,中位年龄35岁。主要临床表现为腹痛(7例)和便血(6例)。9例伴有贫血,包括轻度7例和中度2例。主要MSCT表现:(1)部位,均位于中下腹部回肠系膜游离缘,10例位于脐中线右侧,2例位于脐中线,1例位于脐中线左侧;(2)形态,表现为局部呈盲袋状突出,憩室长径(58.08±28.36)mm,短径(20.31±13.15)mm;(3)内容物,含有液体13例、气体7例、粪石1例;(4)血供,由肠系膜上动脉回肠分支的卵黄管动脉供血;(5)并发症包括憩室周围炎13例、出血6例、穿孔2例和憩室反套2例。憩室内异位胰腺1例,MSCT表现为明显强化的憩室壁结节。本组有3例行核素扫描,异位胃黏膜显像阳性2例、阴性1例。结论:成人MD具有特征性MSCT表现及临床特点,根据病灶定位及征象可帮助实现准确诊断。Objective:To investigate the multi-slice CT(MSCT)features of Meckel′s diverticulum(MD)and its complications in adults.Methods:The clinical data and MSCT findings of 13 adult MD patients from June 2014 to December 2022 were collected.There were 12 men and one women with age of 26~79 years(average 35 years).All patients underwent pre-contrast and contrast-enhanced MSCT scans,and 3 patient underwent ECT scans.All cases were confirmed by clinical criteria and postsurgical pathology.In combination with clinical and imaging features,the MSCT findings were analyzed and summarized.Results:The incidence of adult MD was high in males,and the age distribution was not specific.Clinical manifestations included abdominal pain(7 cases)and hematochezia(6 cases).There were 9 patients with anemia(7 mild and 2 moderate).MSCT findings were as follows:①All lesions were located at the free margin of the middle and lower abdominal mesentery(10 cases were located at the right side of the umbilical midline,2 cases were located at the umbilical midline,and one case was located at the left side of the umbilical midline);②The shape was diverticulose-like protrusion,the long diameter was(58.08±28.36)mm and the short diameter was(20.31±13.15)mm;③Contents in the diverticulums were those containing liquids(13 cases),gases(7 cases)and/or coprolite(one case);④MD blood was supplied by vitel-line pedicle artery of the superior mesenteric artery ileal branch;⑤The complications were peridiverticulitis(13 cases),bleeding(6 cases),perforation(2 cases),and reverse diverticulum(2 cases).Ectopic pancreas in diverticulum in one case was confirmed by postoperative pathology,MSCT showed significantly enhanced nodules on diverticulum wall.Radionuclide scanning showed ectopic gastric mucosa in diverticulum in 2 cases.Conclusion:Adult MD has characteristic MSCT manifestations and clinical features.The location of the lesions and imaging features are helpful for accurate diagnosis.

关 键 词：梅克尔憩室 小肠疾病 异位组织 体层摄影术 X线计算机 并发症 

分 类 号：R814.42[医药卫生—影像医学与核医学] R574.5[医药卫生—放射医学]