结肠憩室炎影像特点及分期的临床价值  

Clinical Value of Imaging Features and Staging of Colonic Diverticulitis

作　　者：周静然 杨峰 ZHOU Jing-ran;YANG Feng(Department of Radiology,Xiangyang No.1 People's Hospital,Hubei University of Medicine,Xiangyang,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院放射科,湖北襄阳441000

出　　处：《湖北医药学院学报》2023年第5期501-504,共4页Journal of Hubei University of Medicine

基　　金：襄阳市第一人民医院科技创新项目(XYY2023SD18)。

摘　　要：目的:总结结肠憩室炎的临床及影像学特点,探讨其影像分期对临床治疗决策的价值。方法:收集我院32例经手术证实或结肠镜检查证实的结肠憩室炎及7例经临床治疗前后影像对比且临床随访证实的结肠憩室炎患者的临床资料,并对其影像学特点进行分析,并根据Sartelli分期预测采用相应的治疗方案。结果:39例患者均行CT扫描,其中8例患者还同时进行了MR检查,24例病变位于升结肠及盲肠,12例位于乙状结肠,3例位于横结肠及降结肠。结肠憩室炎的影像学表现有结肠壁的小囊袋状突起(36/39,92.3%),憩室壁及邻近肠壁水肿增厚(35/39,89.7%),周围脂肪间隙模糊及邻近腹膜增厚(33/39,84.3%),合并结石嵌顿(15/39,38.5%),腹腔积液(8/39,20.5%),腹腔积气(4/39,10.2%),腹腔脓肿(4/39,10.2%)。39例患者影像学检查诊断准确率为(36/39,92.3%)。治疗前进行Sartelli分期预测治疗方案准确性为88.9%(32/36)。结论:结肠憩室炎有一定的特征性影像学表现,影像分期对临床治疗决策有重要的价值。Objective To summarize the clinical and imaging characteristics of colonic diverticulitis and explore the value of imaging staging in clinical treatment decision-making.Methods Collect clinical data of 32 patients with colon diverticulitis confirmed by surgery or colonoscopy in our hospital,as well as 7 patients with colon diverticulitis confirmed by clinical follow-up and imaging comparison before and after treatment.Analyze their imaging characteristics and predict the corresponding treatment plan based on Sartelli staging.Results All 39 patients underwent CT scans,of which 8 patients also underwent MR examination.24 lesions were located in the ascending colon and cecum,12 lesions were located in the sigmoid colon,and 3 lesions were located in the transverse colon and descending colon.The imaging manifestations of colonic diverticulitis include small cystic protrusions on the colon wall(36/39,92.3%),edema and thickening of diverticulum wall and adjacent intestinal wall(35/39,89.7%),blurring of surrounding fat spaces and thickening of adjacent peritoneum(33/39,84.3%),combined with stone incarceration(15/39,38.5%),abdominal fluid accumulation(8/39,20.5%),abdominal air accumulation(4/39,10.2%),and abdominal abscess(4/39,10.2%).The diagnostic accuracy of imaging examination in 39 patients was(36/39,92.3%).The accuracy of Sartelli staging before treatment in predicting treatment plans was(32/36,88.9%).Conclusion Colonic diverticulitis has certain characteristic imaging manifestations,and imaging staging has important value for clinical treatment decision-making.

关 键 词：憩室炎 结肠 体层摄影术 X线计算机 磁共振成像 

分 类 号：R574.62[医药卫生—消化系统]