肠系膜上动脉血栓128层螺旋CT血管成像特征及诊断价值分析
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摘要
目的:分析肠系膜上动脉血栓128层螺旋CT血管成像特征并对CT检查的诊断价值进行探究。方法:回顾性分析2015年5月～2017年12月于我院接受治疗的30例肠系膜上动脉血栓患者128层螺旋CT血管成像资料,探究患者128层螺旋CT血管成像特征。结果:30例患者均存在肠系膜上动脉增粗、血管腔内充盈缺损的情况。其中1例显示腹腔、肠系膜内或者肠壁的气体聚集,2例存在肠系膜水肿,3例存在肠系膜积液,4例患者肠壁明显增厚,6例患者肠系膜不强化,6例患者肠壁变薄,8例患者肠腔扩张、积气或者积液。结论:128层螺旋CT血管成像技术不但能够清楚地反映肠系膜上动脉血栓的血管情况,还具有提示患者肠壁缺血程度的作用,为肠系膜上动脉血栓临床治疗医师治疗方案的制定与实施提供了可靠的影像学支撑,在临床上的应用价值高。
Objective:To analyze the characteristics of 128-slice spiral CT angiography of superior mesenteric artery thrombosis and to investigate the diagnostic value of CT examination.Methods:The 128-slice spiral CT angiography data of 30 patients with superior mesenteric artery thrombosis treated in our hospital from May 2015 to December 2017 were retrospectively analyzed. The characteristics and diagnostic efficacy of 128-slice spiral CT angiography were discussed.Results:30 cases of patients had thickening of the superior mesenteric artery and filling of the lumen of the vessel. 1 of them showed gas accumulation in the peritoneal, mesenteric or intestinal wall, 2 cases had mesenteric edema, 3 cases had mesenteric effusion, 4 cases had thickened intestinal wall, 6 cases had no mesentery, and 6 cases had intestinal wall changes, 8 patients with intestinal dilatation, gas accumulation or effusion.Conclusion:128-slice spiral CT angiography not only can clearly reflect the vascular condition of superior mesenteric artery thrombosis, but also has the effect of suggesting the degree of intestinal wall ischemia. It provides a reliable method for the development and implementation of treatment plan for clinical treatment of superior mesenteric artery thrombosis. Imaging support has high clinical value.
Objective:To analyze the characteristics of 128-slice spiral CT angiography of superior mesenteric artery thrombosis and to investigate the diagnostic value of CT examination.Methods:The 128-slice spiral CT angiography data of 30 patients with superior mesenteric artery thrombosis treated in our hospital from May 2015 to December 2017 were retrospectively analyzed. The characteristics and diagnostic efficacy of 128-slice spiral CT angiography were discussed.Results:30 cases of patients had thickening of the superior mesenteric artery and filling of the lumen of the vessel. 1 of them showed gas accumulation in the peritoneal, mesenteric or intestinal wall, 2 cases had mesenteric edema, 3 cases had mesenteric effusion, 4 cases had thickened intestinal wall, 6 cases had no mesentery, and 6 cases had intestinal wall changes, 8 patients with intestinal dilatation, gas accumulation or effusion.Conclusion:128-slice spiral CT angiography not only can clearly reflect the vascular condition of superior mesenteric artery thrombosis, but also has the effect of suggesting the degree of intestinal wall ischemia. It provides a reliable method for the development and implementation of treatment plan for clinical treatment of superior mesenteric artery thrombosis. Imaging support has high clinical value.
引文
1 姜波.128层螺旋CT血管成像技术在肠系膜上动脉夹层诊断中的运用价值探讨[J].中国医药指南,2017,15(6):164-165.
2 杨天富.多层螺旋CT血管成像在肠系膜上动脉栓塞诊断中的临床应用[J].河北医学,2013,19(7):1048-1050.
3 王瑞军.肠系膜上动脉栓塞的多层螺旋CT诊断探讨[J].影像研究与医学应用,2017,1(12):114-115.
4 刘大方,郝小强,叶颖江,等.急性肠系膜上动脉闭塞性疾病发生肠坏死的早期预测因素[J].中华普通外科杂志,2017,32(4):301-305.
5 张树荣,周文宝,李朝庚,等.急性肠系膜上动脉栓塞的临床诊治研究[J].中华全科医学,2014,12(12):2041-2042.
6 金同梅,高扬娟,张廉良,等.64排螺旋CT血管成像对于急性肠系膜上动脉栓塞的诊断价值[J].中国医学装备,2017,14(11):57-61.
7 吕和平,倪海真,黄景勇,等.肌酸激酶及CT血管造影检查评估肠系膜上动脉栓塞的短期预后[J].中华消化外科杂志,2016,15(8):840-844.
8 张弘,吴忠隐,熊江,等.腹主动脉-肠系膜上动脉夹角在自发性孤立性肠系膜上动脉夹层中的意义[J].中华普通外科杂志,2016,31(2):134-136.
9 陆瑶,李青春,方向军,等.几种常见急性肠系膜上动脉事件的多层螺旋CT血管造影诊断[J].中国动脉硬化杂志,2018,26(2):190-193.
10 李树昌,杨宏,赵红军.MSCT血管造影在急性肠系膜上动脉栓塞诊断中的价值[J].医学影像学杂志,2012,22(2):305-307.
11 蔡庆虎,张燕绒,张海荣,等.缺血性肠病所致肝门静脉和肠壁积气的螺旋CT影像特征与诊断价值[J].中华肝胆外科杂志,2017,23(5):296-299.
12 赵欣,张浩,曾红辉,等.CT肠壁积气征在评估肠管血运活性上的意义[J].影像诊断与介入放射学,2012,21(6):419-423.
13 吴晓东,赵衡.多层螺旋CT肠系膜血管成像对肠系膜上动脉疾病的诊断[J].中南医学科学杂志,2015,43(2):204-205,209.
14 马跃虎,吴刚,刘浩,等.多层螺旋CT血管成像在肠系膜上动脉缺血性疾病诊断中的应用[J].山东医药,2014,54(43):48-50.
15 李海飞,衣高峰.64层螺旋CT血管重建诊断肠系膜上动脉及相关病变[J].医学影像学杂志,2016,26(6):1048-1051.
16 盛美红,何伯圣,龚沈初,等.Thin-MIP不同重组方式在肠系膜上动脉及其分支显示中的价值[J].南京医科大学学报(自然科学版),2014,34(2):249-252.
2 杨天富.多层螺旋CT血管成像在肠系膜上动脉栓塞诊断中的临床应用[J].河北医学,2013,19(7):1048-1050.
3 王瑞军.肠系膜上动脉栓塞的多层螺旋CT诊断探讨[J].影像研究与医学应用,2017,1(12):114-115.
4 刘大方,郝小强,叶颖江,等.急性肠系膜上动脉闭塞性疾病发生肠坏死的早期预测因素[J].中华普通外科杂志,2017,32(4):301-305.
5 张树荣,周文宝,李朝庚,等.急性肠系膜上动脉栓塞的临床诊治研究[J].中华全科医学,2014,12(12):2041-2042.
6 金同梅,高扬娟,张廉良,等.64排螺旋CT血管成像对于急性肠系膜上动脉栓塞的诊断价值[J].中国医学装备,2017,14(11):57-61.
7 吕和平,倪海真,黄景勇,等.肌酸激酶及CT血管造影检查评估肠系膜上动脉栓塞的短期预后[J].中华消化外科杂志,2016,15(8):840-844.
8 张弘,吴忠隐,熊江,等.腹主动脉-肠系膜上动脉夹角在自发性孤立性肠系膜上动脉夹层中的意义[J].中华普通外科杂志,2016,31(2):134-136.
9 陆瑶,李青春,方向军,等.几种常见急性肠系膜上动脉事件的多层螺旋CT血管造影诊断[J].中国动脉硬化杂志,2018,26(2):190-193.
10 李树昌,杨宏,赵红军.MSCT血管造影在急性肠系膜上动脉栓塞诊断中的价值[J].医学影像学杂志,2012,22(2):305-307.
11 蔡庆虎,张燕绒,张海荣,等.缺血性肠病所致肝门静脉和肠壁积气的螺旋CT影像特征与诊断价值[J].中华肝胆外科杂志,2017,23(5):296-299.
12 赵欣,张浩,曾红辉,等.CT肠壁积气征在评估肠管血运活性上的意义[J].影像诊断与介入放射学,2012,21(6):419-423.
13 吴晓东,赵衡.多层螺旋CT肠系膜血管成像对肠系膜上动脉疾病的诊断[J].中南医学科学杂志,2015,43(2):204-205,209.
14 马跃虎,吴刚,刘浩,等.多层螺旋CT血管成像在肠系膜上动脉缺血性疾病诊断中的应用[J].山东医药,2014,54(43):48-50.
15 李海飞,衣高峰.64层螺旋CT血管重建诊断肠系膜上动脉及相关病变[J].医学影像学杂志,2016,26(6):1048-1051.
16 盛美红,何伯圣,龚沈初,等.Thin-MIP不同重组方式在肠系膜上动脉及其分支显示中的价值[J].南京医科大学学报(自然科学版),2014,34(2):249-252.