CT平扫对肠系膜上动脉夹层的诊断价值  

Diagnostic value of CT plain scan for isolated superior mesenteric artery dissection

作　　者：邱顺 黄钺淇 罗光华[2] 黄秋林[1] 李青春[2] QIU Shun;HUANG Yueqi;LUO Guanghua;HUANG Qiulin;LI Qingchun(Department of Gastrointestinal Surgery,the First Affiliated Hospital of University of South China,Hengyang,Hu’nan Province 421001,China;Department of Radiology and Medical Imaging,the First Affiliated Hospital of University of South China,Hengyang,Hu’nan Province 421001,China)

机构地区：[1]南华大学附属第一医院胃肠外科,湖南衡阳421001 [2]南华大学附属第一医院放射影像中心,湖南衡阳421001

出　　处：《实用放射学杂志》2024年第6期922-925,930,共5页Journal of Practical Radiology

基　　金：湖南省自然科学基金项目(2021JJ70118);湖南省卫生健康委员会基金项目(20201919,20201956)。

摘　　要：目的探讨CT平扫对孤立性肠系膜上动脉夹层(ISMAD)的诊断价值。方法回顾性分析45例ISMAD患者和45例非ISMAD患者的肠系膜上动脉(SMA)CT平扫图像及ISMAD的影像学表现特征,采用受试者工作特征(ROC)曲线分析其敏感度、特异度。结果2组SMA主干直径、SMA主干标准化直径的差异有统计学意义(P<0.001,P=0.001),SMA主干直径诊断ISMAD的曲线下面积(AUC)为0.988,P<0.001,当SMA主干直径达8.20 mm时,其诊断敏感度97.8%,特异度93.3%。SMA主干标准化直径的AUC为0.976,且SMA主干标准化直径达70.33%时,其诊断敏感度95.6%,特异度82.2%。2组SMA管腔CT值、标准化CT值差异无统计学意义(P>0.05)。SMA“新月征”、管周脂肪模糊具有一定参考价值。结论CT平扫可以发现SMA主干直径增大、“新月征”等表现,对于ISMAD的诊断具有积极意义,并为是否需要进一步行CT血管成像(CTA)检查提供依据。Objective To investigate the diagnostic value of CT plain scanning for isolated superior mesenteric artery dissection(ISMAD).Methods This study retrospectively investigated CT plain images of the superior mesenteric artery(SMA)in 45 patients with ISMAD and 45 patients without ISMAD.The imaging manifestations of ISMAD were analyzed,and the sensitivity and specificity of these manifestations were analyzed using receiver operating characteristic(ROC)curve.Results There were statistically significant differences in both the trunk diameter and standardized trunk diameter of the SMA between the two groups(P<0.001,P=0.001).Additionally,the area under the curve(AUC)for the SMA trunk diameter in diagnosing ISMAD was determined to be 0.988,with a statistically significant P-value of less than 0.001.Furthermore,when the diameter of the SMA trunk reached 8.20 mm,the diagnostic sensitivity was 97.8%and the specificity was 93.3%.The AUC for the standardized diameter of the SMA trunk was determined to be 0.976.Additionally,when the standardized diameter of the SMA trunk reached 70.33%,the diagnostic sensitivity was 95.6%and the specificity was 82.2%.There was no statistically significant difference observed in the luminal CT value and standardized CT value of the SMA between the two groups(P>0.05).Additionally,the presence of the“crescent sign”and peritubular fat blurring in the SMA demonstrated some level of diagnostic significance.Conclusion CT scanning has the capability to identify the enlarged diameter of the SMA trunk,as well as plain the“crescent sign”and related manifestations.This finding holds significant value in diagnosing ISMAD.Furthermore,it provides the basis for the necessity of subsequent computed tomography angiography(CTA)examinations.

关 键 词：肠系膜上动脉 夹层 计算机体层成像 

分 类 号：R572.3[医药卫生—消化系统] R814.42[医药卫生—内科学]