摘要
目的评价磁共振单次激发快速自旋回波T2加权成像(SS-TSE-T2WI)序列对绞窄性肠梗阻的诊断价值,总结绞窄性肠梗阻的影像学征象。方法回顾性分析烟台市莱阳中心医院2019-06-01-2022-07-31收治的粘连性小肠梗阻患者的MR资料50例,其中绞窄组18例,非绞窄组32例;采用飞利浦Achieva 1.5T超导磁共振扫描仪,应用8通道腹部线圈采集信号,单次激发快速自旋回波SS-TSE-T2WI,对所有粘连性肠梗阻患者梗阻段肠壁及肠腔积液T2WI表现进行影像学分析,判断SS-TSE-T2WI成像对绞窄性肠梗阻的诊断价值。结果18例绞窄组患者磁共振SS-TSE-T2WI成像均显示梗阻段肠壁水肿高信号、黏膜面环形低信号,称之为“黑靶环征”,对绞窄性肠梗阻有较高的阳性预测值、诊断特异度和灵敏度(均为100.00%);另有8例梗阻肠腔内积液呈T2WI均匀低信号或低信号液液平面,称之为“黑积液征”,绞窄组肠梗阻的“黑积液征”(8/18,44.44%)的发生率远高于非绞窄组(2/32,6.25%),差异有统计学意义,χ^(2)=8.252,P=0.004,对绞窄的诊断具有一定的灵敏度(44.44%)和特异度(93.75%)。结论磁共振SS-TSE-T2WI成像提示梗阻段肠壁的“黑靶环征”以及梗阻肠腔的“黑积液征”对于绞窄性肠梗阻的诊断具有显著的特异性,从而有助于指导临床对肠梗阻治疗方案的制定。
Objective To evaluate the diagnostic value of MR single-shot turbo spin echo T2-weighted imaging(SS-TSE-T2WI)in strangulated intestinal obstruction and summarize the specific imaging signs of strangulated intestinal obstruction.Methods From June 1,2019to July 31,2022,the MR data of 50patients with adhesive small intestinal obstruction admitted to Laiyang Center Hospital of Yantai were analyzed retrospectively,including 18cases in the strangulated group and 32cases in the nonstrangulated group.A Philips Achieva 1.5Tsuperconducting magnetic resonance scanner was used to collect signals using an 8-channel abdominal coil.Single shot fast spin echo SS-TSE-T2WI was performed to analyze the T2WI manifestations of the obstructed intestinal wall and intestinal cavity effusion in all patients with adhesive intestinal obstruction.The diagnostic value of SS-TSE-T2WI imaging for strangulated intestinal obstruction was evaluated.Results The magnetic resonance SS-TSE-T2WI imaging of 18patients in the strangulated group showed high signal of intestinal wall edema in the obstructed segment and circular low signal of the mucosal surface,which was called"black target ring sign".This sign had a high positive predictive value,diagnostic specificity and sensitivity for strangulated intestinal obstruction(all were 100.00%).In addition,8cases of obstructive intestinal effusion showed uniform low signal or low signal fluid level on T2WI,which was called"hydrocele nigra sign".The incidence of"hydrocele nigra"of intestinal obstruction in strangulated group(8/18,44.44%)was significantly higher than that in non-strangulated group(2/32,6.25%).The difference was statistically significant(χ^(2)=8.252,P=0.004),and SS-TSE-T2WI imaging had certain sensitivity(44.44%)and significant specificity(93.75%)in the diagnosis of strangulation.Conclusion SSTSE-T2WI imaging shows that the"black target ring sign"of the intestinal wall of the obstructive segment and the"hydrocele nigra sign"of the obstructive intestinal cavity have significant specificity for the diagnosis of strangulated intestinal obstruction,which is helpful to guide the clinical treatment of intestinal obstruction.
作者
曲林涛
盖风
程永远
QU Lintao;GAI Feng;CHENG Yongyuan(Department of Radiology,Laiyang Center Hospital of Yantai,Yantai 265200,China)
出处
《社区医学杂志》
CAS
2023年第14期736-740,共5页
Journal Of Community Medicine
基金
烟台市科技计划(2022YD117)。
关键词
绞窄性肠梗阻
磁共振成像
影像学诊断
黑靶环征
黑积液征
单次激发快速自旋回波T2加权成像
strangulated intestinal obstruction
magnetic resonance imaging
imaging diagnosis
black target ring sign
hydrocele nigra sign
single-shot turbo spin echo T2-weighted imaging
