CT小肠成像对肠梗阻部位及病因的诊断价值

发布时间：2018-01-10 19:33

本文关键词：CT小肠成像对肠梗阻部位及病因的诊断价值　出处：《中国CT和MRI杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的研究CT小肠成像对肠梗阻部位及病因的诊断价值。方法选取我院2012年9月至2014年9月46例经手术病理证实肠梗阻患者为研究对象,采取美国GE Lightspeed64层螺旋CT仪进行平扫及三期增强扫描,分析MSCT对肠梗阻的检出率、病因和梗阻部位的判断价值。结果 46例肠梗阻患者均检出,检出率100%,27例移行带显示清晰,46例患者均可见肠管明显扩张(2.5cm)、积气及积液;病理证实高、低位梗阻均为23例,CT检查结果高位梗阻27例,低位梗阻19例,梗阻定位准确性91.30%(42/46);手术病理诊断粘连性肠梗阻16例,肠套叠肠梗阻6例,血运性肠梗阻4例,外伤性肠梗阻2例,内疝1例,肠扭转2例,肿瘤性肠梗阻12例,肿瘤压迫型梗阻3例,CT诊断粘连性肠梗阻12例,肠套叠肠梗阻7例,血运性肠梗阻4例,外伤性肠梗阻2例,肠扭转3例,肿瘤性肠梗阻16例,肿瘤压迫型梗阻3例。误诊5例,4例粘连性肠梗阻误诊为肿瘤性肠梗阻,1例内疝误诊为肠扭转,病因诊断准确率89.13%(5/46)。结论 CT小肠成像对肠梗阻的诊断准确度高,且用于肠梗阻病因、部位的鉴别有较高的准确性,可为后期治疗、随访等提供可靠依据。
[Abstract]:Objective to study the diagnostic value of CT small bowel imaging on the location and etiology of intestinal obstruction. Methods 46 patients with intestinal obstruction confirmed by operation and pathology from September 2012 to September 2014 were selected as the study objects. The detection rate of intestinal obstruction by MSCT was analyzed by using GE Lightspeed64 slice spiral CT and three phase enhanced scanning. Results all 46 cases of intestinal obstruction were detected. The detectable rate was 100% and 27 cases showed clear transition zone. In 46 cases, there was significant dilation of intestinal duct (2.5 cm). Accumulation of gas and fluid; Ct findings: 27 cases of high obstruction and 19 cases of low obstruction were confirmed by pathology. The accuracy of location of obstruction was 91.30 / 42 / 46. There were 16 cases of adhesive intestinal obstruction, 6 cases of intussusception, 4 cases of blood circulation, 2 cases of traumatic intestinal obstruction, 1 case of internal hernia, 2 cases of intestinal volvulus and 12 cases of neoplastic intestinal obstruction. 12 cases of adhesive intestinal obstruction, 7 cases of intussusception obstruction, 4 cases of blood circulation obstruction, 2 cases of traumatic intestinal obstruction, 3 cases of intestinal volvulus and 16 cases of neoplastic intestinal obstruction were diagnosed by CT. 5 cases of adhesive intestinal obstruction were misdiagnosed as neoplastic intestinal obstruction and 1 case of internal hernia was misdiagnosed as volvulus of intestine. Conclusion CT small bowel imaging has a high accuracy in the diagnosis of intestinal obstruction and is used in the etiology of intestinal obstruction. Follow-up provides reliable evidence.
【作者单位】：中国人民解放军空军总医院普通外科;
【分类号】：R574.2;R816.5
【正文快照】： 小肠梗阻为胃肠常见综合征,主要指小肠内因梗阻导致内容物移行不畅,临床表现较多且复杂,无法单一根据症状确诊,以往主要采取腹部平片诊断,但腹部平片对梗阻定位不够准确、且不能明确梗阻病因,因此准确、全面的诊断方式成为临床研究的重点[1]。近年随着CT技术的成熟,CT已成为肠

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