摘要
目的探讨多层螺旋CT(MSCT)诊断急性肠缺血的临床应用价值。方法回顾性分析24例经临床证实的急性肠缺血患者的CT表现。所有患者均行CT检查,包括平扫、动脉期、门脉期扫描及血管重建,2例行MSCT灌注扫描;21例行DSA检查及介入治疗;3例行肠切除手术。结果应用MSCT血管重建技术诊断肠系膜上静脉血栓形成13例、肠系膜上动脉栓塞5例、肠系膜上动脉狭窄5例、腹腔干狭窄1例。不同病因和不同程度的肠缺血CT间接征象有一定差异:肠系膜静脉血栓形成时,肠壁增厚、肠系膜水肿、腹水多见;肠壁积气仅见于全层坏死,而其他征象均可见于不同病因、不同程度的肠缺血。结论MSCT能准确诊断肠缺血并明确病因,有助于判断缺血程度。
Objective To retrospectively explore the clinical value of multi-slice helical CT（MSCT） in the diagnosis of acute intestinal ischemia.Methods MSCT（plain scan,arterial and portal vein phase scan,and then vessel reconstruction） was performed in 24 patients with acute intestinal ischemia.Of the 24 patients,21 underwent digital subtraction angiography and interventional treatment procedure,and the 3 others were treated with enterotomy.Results The causes of acute intestinal ischemia in the 24 patients were accurately revealed on MSCT as superior mesenteric vein thrombosis（n=13）,superior mesenteric artery embolism（n=5）,superior mesenteric artery stenosis（n=5） and celiac trunk stenosis（n=1）.The indirect CT findings included luminal dilatation,wall thickening or thinning,wall pneumatosis,mesenteric edema,abnormal density,reduction or absence of wall enhancement.The bowel wall thickening,mesenteric edema and ascites were observed in most patients with superior mesenteric vein thrombosis,and the wall pneumatosis was only seen in patients with transmural infarction.Conclusion The integrative MSCT examination has great value in the diagnosis of the acute intestinal ischemia,which can identify the causes,and estimate the ischemic degree.
出处
《首都医科大学学报》
CAS
2007年第6期743-747,共5页
Journal of Capital Medical University
关键词
肠缺血
体层摄影术
X线计算机
intestinal ischemia,tomography,X-ray computer
