急性钝性或穿通性肠管损伤的多层螺旋CT征象分析  

Analysis of multi spiral CT features of acute blunt or penetrating intestinal injury

作　　者：黄英荷[1] 白雄军 李应棋 黄嘉成[1] 鲍俊初[1] 杜绪仓[1] 梁久平 HUANG Yinghe;BAI Xiongjun;LI Yingqi;HUANG Jiacheng;BAO Junchu;DU Xucang;LIANG Jiuping(Department of Radiology,Shenzhen Bao’an District Songgang People’s Hospital,Shenzhen,Guangdong Province 518105,China)

机构地区：[1]深圳市宝安区松岗人民医院放射科,广东深圳518105

出　　处：《实用放射学杂志》2024年第4期595-597,640,共4页Journal of Practical Radiology

摘　　要：目的分析急性钝性或穿通性肠管损伤的CT征象,提高对肠管损伤的多层螺旋CT诊断准确性。方法收集进行急诊CT检查,并经临床手术探查证实的63例肠管损伤患者的CT及临床资料,对照分析CT表现与临床手术所见。结果肠管损伤63例,其中26例合并肠系膜损伤。肠管损伤的直接CT征象包括肠壁增厚征64%(40/63)、肠管不连续征17%(10/63);肠管损伤的间接CT征象包括腹腔/腹膜后气体征72%(45/63)、腹腔/腹膜后积液征88%(55/63)、黏膜积气7%(5/63)及门静脉积气5%(3/63)。结论认识肠壁增厚征、肠管不连续征、腹腔/腹膜后气体征、腹腔/腹膜后积液征、黏膜积气及门静脉积气等肠管损伤CT征象,结合临床可早期正确诊断肠管损伤。Objective To analyze the CT signs of acute blunt or penetrating intestinal injury,and to improve the diagnostic accuracy of multi spiral CT for intestinal injury.Methods The CT and clinical data of 63 patients with intestinal injury confirmed by clinical surgical exploration who underwent emergency CT scan were collected,and the CT findings and surgical findings were comparatively analyzed.Results There were 63 cases of intestinal injury,of which 26 cases were complicated with mesenteric injury.The direct CT signs of intestinal injury included intestinal wall thickening sign and intestinal discontinuity sign,which accounted for 64%(40/63)and 17%(10/63),respectively.The indirect CT signs of intestinal injury included intraperitoneal/retroperitoneal gas sign,intraperitoneal/retroperitoneal effusion sign,intramural air,and portal venous gas,which accounted for 72%(45/63),88%(55/63),7%(5/63)and 5%(3/63),respectively.Conclusion Recognizing the CT signs of intestinal injury,such as intestinal wall thickening sign,intestinal discontinuity sign,intraperitoneal/retroperitoneal gas sign,intraperitoneal/retroperitoneal effusion sign,intramural air,and portal venous gas can help to make the early and correct diagnosis of intestinal injury if combined with clinical practice.

关 键 词：肠管 损伤 计算机体层成像 

分 类 号：R574[医药卫生—消化系统] R814.42[医药卫生—内科学]