MSCT对于急性肠坏死的诊断价值
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摘要
目的:探讨急性肠坏死的多层螺旋CT(MSCT)影像表现及临床价值。方法:回顾性分析2015—2018年12例经手术证实发生肠坏死的急腹症患者MSCT影像资料,同时应用多平面重组(MPR)后处理技术进行观察。结果:12例病例均提示伴随肠梗阻、肠壁水肿等表现,CT表现为肠系膜血管充盈缺损、推拉移位;肠管聚集,肠腔扩张积气及气液平改变,不同程度的腹腔积液积血;肠系膜局部脂肪密度增高。结论:MSCT及其后处理重建方法是一种有效的诊断技术,对急性肠坏死具有重要的诊断价值,为临床治疗提供可靠依据。
Objective Explore the clinical value of multislice spiral CT(MSCT) in acute intestinal necrosis.Methods The MSCT imaging data of 12 cases of acute abdomen with confirmed intestinal necrosis in 2015-2018 were retrospectively analyzed. Results All of the 12 cases indicated that they were accompanied by intussusception and intestinal wall edema, and the CT showed that the intestinal tube was clustered and enveloped, the intestinal expansion and gas-liquid level were changed, and the abdominal hydrops were hematocele to varying degrees. Local fat density in mesentery increased; The mesenteric vessels are displaced and stretched. Conclusion MSCT and its post-treatment reconstruction is an effective diagnostic technique, which has important diagnostic value for acute intestinal necrosis and provides a reliable basis for clinical treatment.
Objective Explore the clinical value of multislice spiral CT(MSCT) in acute intestinal necrosis.Methods The MSCT imaging data of 12 cases of acute abdomen with confirmed intestinal necrosis in 2015-2018 were retrospectively analyzed. Results All of the 12 cases indicated that they were accompanied by intussusception and intestinal wall edema, and the CT showed that the intestinal tube was clustered and enveloped, the intestinal expansion and gas-liquid level were changed, and the abdominal hydrops were hematocele to varying degrees. Local fat density in mesentery increased; The mesenteric vessels are displaced and stretched. Conclusion MSCT and its post-treatment reconstruction is an effective diagnostic technique, which has important diagnostic value for acute intestinal necrosis and provides a reliable basis for clinical treatment.
引文
[1]陈明,李选,谢敬霞.急性肠缺血的多层螺旋CT评价[N].中国医学科学院学报,2006,28(1):80-83,彩插7,彩插8.
[2]杨颖,韩飞,田笑,等.急性肠缺血的多层螺旋CT诊断[J].实用放射学杂志,2010,26(12):1771-1773,1780.
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[5]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.
[6]强金伟,李若坤,冯晓源,等.采用多排螺旋CT评价肠系膜动脉栓塞致急性肠缺血的实验研究[J].中华胃肠外科杂志,2010,13(2):151-155.
[7]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.
[8]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.
[9]张冠业,贾红明,李苒光,龚建安,邓博,欧鸿儒,莫家彬,简坚成,苏耀斌.螺旋CT增强多期扫描的相对强化值在绞窄性肠梗阻中判断缺血性肠坏死的诊断价值[J].胃肠病学和肝病学杂志,2016,25(1):77-79.
[10]王晓阳,李阳,高源统,罗敏,李振勋.多层螺旋CT在肠系膜静脉血栓诊断中的应用[J].实用放射学杂志,2007,23(4):481-483.
[11]Wiesner W,Khurana B,ji H.et al.CT of acute bowel ischemia[J].Radiology,2003,226:635-650.
[12]Saba L,Mallarini G.Spiral computed tomography imaging of bowel is chemia:a literature review[J].Panminerva Med,2007,49(1):35-41.
[13]Ahualli J.The target sign:bowel wall[J].Radiology,2005,234:549.
[2]杨颖,韩飞,田笑,等.急性肠缺血的多层螺旋CT诊断[J].实用放射学杂志,2010,26(12):1771-1773,1780.
[3]韩新洪,袁华.高频结合彩色多普勒超声对小儿肠套叠的诊断意义[J].中国超声诊断杂志,2006,7(5):357-358
[4]赵忠,李振敏,戚胜杰,刘绍敏,王惠,陶玲,等.彩色多普勒超声在小儿肠套叠选择复位方式中价值[J].中华超声影像学杂志,2001,10(4):225-227.
[5]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.
[6]强金伟,李若坤,冯晓源,等.采用多排螺旋CT评价肠系膜动脉栓塞致急性肠缺血的实验研究[J].中华胃肠外科杂志,2010,13(2):151-155.
[7]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.
[8]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.
[9]张冠业,贾红明,李苒光,龚建安,邓博,欧鸿儒,莫家彬,简坚成,苏耀斌.螺旋CT增强多期扫描的相对强化值在绞窄性肠梗阻中判断缺血性肠坏死的诊断价值[J].胃肠病学和肝病学杂志,2016,25(1):77-79.
[10]王晓阳,李阳,高源统,罗敏,李振勋.多层螺旋CT在肠系膜静脉血栓诊断中的应用[J].实用放射学杂志,2007,23(4):481-483.
[11]Wiesner W,Khurana B,ji H.et al.CT of acute bowel ischemia[J].Radiology,2003,226:635-650.
[12]Saba L,Mallarini G.Spiral computed tomography imaging of bowel is chemia:a literature review[J].Panminerva Med,2007,49(1):35-41.
[13]Ahualli J.The target sign:bowel wall[J].Radiology,2005,234:549.