等渗低张MSCTE小肠造影对小肠粘连的诊断价值  

Study on the Diagnostic Value of Isotonic Hypotonic MSCTE Enterography for Small Intestinal Adhesion

作　　者：依力亚斯江·塔瓦库力 刘新立[1] 于江[1] Elias Jiang Tawakuli;Liu Xinli;Yu Jiang(Karamay Central Hospital,Keramay,Xinjiang 834000)

机构地区：[1]克拉玛依市中心医院,新疆克拉玛依834000

出　　处：《现代医用影像学》2023年第6期1058-1062,共5页Modern Medical Imageology

摘　　要：目的:评价等渗低张多层螺旋CT小肠造影(MSCTE)在诊断小肠粘连中的价值。方法:收集我院腹腔术后且反复发作肠梗阻的患者,所有受检者均在肠梗阻缓解期行MSCTE检查,并在一个月后行择期腹腔镜手术。经过后处理,MSCTE图像由两名高年资影像诊断医师独立阅片,判断有无小肠梗阻,确定梗阻部位及明确梗阻原因。分析并记录小肠粘连的影像特点,包括小肠的分布、位置,管腔外形,粘连带,肠系膜血管走行,腹膜的改变。将MSCTE诊断结果与择期手术结果对照分析。结果:纳入的44例病例均完成了MSCTE检查。经MSCTE诊断的小肠粘连者44例,以上患者均与腹腔镜手术对照证实,其中肠管间粘连25例(56.8%),小肠与术区瘢痕粘连10例(22.7%),肠管与腹壁粘连9例(20.4%),MSCTE诊断小肠术后粘连的准确率为100%。小肠粘连的典型CT表现为肠管外形及管腔形态的改变44例(100%),小肠位置固定,肠管异常堆积37例(84.1%),小肠肠系膜血管走行异常24例(54.5%)。结论:MSCTE技术可以提高小肠结构的显示能力,能更好地显示术后小肠粘连的较具特征的影像表现,对该病的诊断具有重要临床价值,值得推广应用。Objective:To evaluate the value of isotonic hypotonic multislice spiral CT enterography(MSCTE)in the diagnosis of intestinal adhesions.Methods:Patients with recurrent intestinal obstruction after abdominal surgery in our hospital were collected.All subjects underwent MSCTE examination at the remission stage of intestinal obstruction,and underwent elective laparoscopic surgery one month later.After post-processing,the MSCTE images were reviewed independently by two senior imaging diagnostitists to determine whether there was small intestinal obstruction,determine the obstruction site and determine the cause of obstruction.The imaging features of small intestinal adhesions were analyzed and recorded,including the distribution and location of small intestine,lumen shape,adhesions,mesenteric vascular flow,and peritoneal changes.The results of MSCTE diagnosis were compared with those of elective surgery.Results:All the 44 included cases completed MSCTE examination.Among the 44 cases of intestinal adhesion diagnosed by MSCTE,the above patients were confirmed by comparison with laparoscopic surgery,including 25 cases(56.8%)of intestinal interduct adhesion,10 cases(22.7%)of intestinal adhesion to the operative area,and 9 cases(20.4%)of intestinal adhesion to the abdominal wall.The accuracy rate of MSCTE in the diagnosis of intestinal adhesion after intestinal surgery was 100%.The typical CT manifestations of intestinal adhesion were 44 cases(100%)of intestinal tube shape and lumen shape change,small intestine location fixation,abnormal intestinal tube accumulation in 37 cases(84.1%),abnormal intestinal mesenteric vascular flow in 24 cases(54.5%).Conclusion:MSCTE technique can improve the display ability of small intestine structure and better display the characteristic image manifestations of postoperative small intestine adhesion,which has important clinical value for the diagnosis of this disease and is worthy of popularization and application.

关 键 词：等渗 甘露醇 小肠粘连 多层螺旋CT 小肠造影 

分 类 号：R816.5[医药卫生—放射医学] R574.5[医药卫生—临床医学]