大小肠双充盈法肠道CT造影对不明原因消化道出血的诊断价值

发布时间：2018-04-23 01:04

本文选题：消化系统疾病 + 出血　；参考：《中国临床医学影像杂志》2016年02期

【摘要】：目的:探讨大小肠双充盈法肠道CT造影对不明原因消化道出血(OGIB)的诊断价值。方法:回顾性分析30例OGIB患者临床资料,所有病例均作大小肠双充盈法肠道CT造影检查。结果:30例中恶性肿瘤5例,小肠间质瘤4例,脂肪瘤1例,血管粗大畸形4例,毛细血管扩张2例,炎性肠病5例,肠息肉3例,肠系膜上动脉血栓形成2例,肠系膜静脉血栓形成1例,憩室2例,异位胰腺1例。10经手术病理证实,6例经胶囊内镜证实,4例血管病变经DSA证实,其余10例肠道CT造影诊断与临床诊断相吻合。本组应用大小肠双充盈法肠道CT造影诊断准确率为73.3%。遗漏的病变分别为血管畸形2例,毛细血管扩张2例,小的息肉病变2例,小肠黏膜充血糜烂2例,遗漏原因为扩张的血管细小,小的息肉与肠黏膜难以区分,黏膜浅表性病变显示不敏感。结论:大小肠双充盈法肠道CT造影对OGIB的定位、定性诊断和指导临床制定治疗方案具有重要临床价值,但易漏诊浅表黏膜面病变及血管病变。
[Abstract]:Objective: to evaluate the diagnostic value of double-filling intestinal CT in patients with unknown gastrointestinal bleeding. Methods: the clinical data of 30 patients with OGIB were analyzed retrospectively. Results among 30 cases, 5 cases were malignant tumor, 4 cases were small intestinal stromal tumor, 1 case was lipoma, 4 cases were macrovascular malformation, 2 cases were capillary dilatation, 5 cases were inflammatory bowel disease, 3 cases were intestinal polyp, 2 cases were thrombosis of superior mesenteric artery. Mesenteric venous thrombosis in 1 case, diverticulum in 2 cases, ectopic pancreas in 1 case and ectopic pancreas in 1 case. 6 cases were confirmed by capsule endoscopy and 4 cases by DSA. The diagnostic accuracy of double filling small intestine CT was 73.3%. The missing lesions were vascular malformation (n = 2), capillary dilatation (n = 2), small polyp (n = 2), small intestinal mucosal congestion and erosion (n = 2). Superficial mucosal lesions were insensitive. Conclusion: double filling small intestine CT angiography has important clinical value in the localization, qualitative diagnosis and guidance of clinical treatment for OGIB, but it is easy to miss the diagnosis of superficial mucosal lesions and vascular lesions.
【作者单位】：江苏省扬中市人民医院影像科;
【分类号】：R57;R816.5

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