CT血管成像对肠系膜上动脉压迫综合征的诊断价值  

Diagnostic value of CT angiography in superior mesenteric artery syndrome

作　　者：徐昌民 芦春花[1] 罗艳[1] 李岩[1] 邢姗姗 XU Changmin;LU Chunhua;LUO Yan;LI Yan;XING Shanshan(Medical Imaging Center,the Second Affiliated Hospital of Nanchang University,Jiangxi Province,Nanchang 330000,China)

机构地区：[1]南昌大学第二附属医院医学影像中心,江西南昌330000

出　　处：《中国当代医药》2024年第19期82-85,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204279)。

摘　　要：目的探究CT血管成像(CTA)对肠系膜上动脉压迫综合征(SMAS)的诊断价值。方法回顾性分析2021年4月至2023年4月于南昌大学第二附属医院就诊的出现类似幽门梗阻而怀疑SMAS的70例患者的临床资料,所有患者均行上消化道造影与CTA检查。其中经上消化道造影检测后确诊为SMAS组38例,非SMAS组32例,比较CTA下SMAS组与非SMAS的相关指标[SMA走行,SMA与腹主动脉(AA)夹角(SMA-AA),胃腔充盈态仰卧位十二指肠通过处SMA后壁与AA前壁的距离(DD)],分析CTA的相关指标对SMAS的诊断价值。结果CTA中,SMAS组的SMA走行的径直型比例高于非SMAS组,差异有统计学意义(P<0.05);SMAS组的SMA-AA及DD均低于非SMAS组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,SMA-AA与DD联合诊断SMAS的AUC为0.919,高于单一指标的0.835、0.773。结论CTA能显示血管走行情况,反映SMA与AA间的夹角及距离,可准确诊断出SMAS,达到与上消化道造影同样效果,临床上可结合患者情况、医疗条件进行选择。Objective To explore the diagnostic value of CT angiography(CTA)in superior mesenteric artery syndrome(SMAS).Methods The clinical data of 70 patients with suspected SMAS due to pyloric obstruction in the Second Affiliated Hospital of Nanchang University were selected from April 2021 to April 2023 were retrospectively analyzed,and all the patients were underwent upper gastrointestinal angiography and CTA.It was confirmed by upper gastrointestinal angiography that there were 38 cases in SMAS group and 32 cases in non-SMAS group.The relevant indexes(SMA travelling,intersection angle of SMA and abdominal aorta[AA][SMA-AA],distance between the posterior wall of SMA and the anterior wall of AA[DD]at duodenal passage in gastric filling and supine position state by CTA in SMAS group and non-SMAS group were compared.The diagnostic value of CTA related indexes for SMAS was analyzed.Results In CTA,proportion of straight type SMA in SMAS group was higher than that in non-SMAS group,with a statistically significant difference(P<0.05).While the SMA-AA and DD were lower than those in non-SMAS group,with statistically significant differences(P<0.05).ROC curves analysis showed that AUC of SMA-AA combined with DD in the diagnosis of SMAS was 0.919,greater than those of single index(0.835,0.773).Conclusion CTA can display vessels travelling,reflect the intersection angle and distance between SMA and AA,accurately diagnose SMAS and achieve the same effect as upper gastrointestinal angiography.Clinically,CTA can be chosen based on patient's conditions and medical conditions.

关 键 词：肠系膜上动脉压迫综合征 上消化道造影 CT血管成像 诊断价值 

分 类 号：R445[医药卫生—影像医学与核医学]