粘连性小肠梗阻的MSCT征象分析

发布时间：2018-04-08 20:22

本文选题：小肠梗阻　切入点：肠粘连　出处：《放射学实践》2017年08期

【摘要】：目的:探讨粘连性肠梗阻的MSCT表现及其诊断价值。方法:回顾性分析45例经临床(15例)和手术病理(30例)证实的粘连性肠梗阻患者的CT资料,所有患者行腹部CT平扫及动态增强扫描。结果:主要CT表现:扩张肠管与塌陷或狭窄肠管伴行45例;肠管与前腹壁以及肠管之间粘连37例,粘连带21例;梗阻处肠管呈"鸟嘴样"狭窄30例,肠管"成角征"6例;梗阻近侧肠管管径均25mm,梗阻程度(扩张与狭窄肠管管径之比)为1.9~3.5、3.6~5.0、5.1~6.5和6.5的患者分别有9、14、16和6例,其梗阻近侧肠管管径依次为(34.98±4.75)、(36.41±7.27)、(40.54±6.90)和(42.67±6.42)mm,梗阻远侧管管径依次为(12.19±2.62)、(8.21±1.78)、(6.81±1.10)和(5.16±2.79)mm,不同梗阻程度间远侧肠管管径的差异有统计学意义(F=26.63,P0.01)。梗阻近侧肠管常见征象:肠壁缺血表现29例,腹内疝21例,肠扭转20例。结论:粘连性肠梗阻的MSCT表现有一定特征性,MSCT后处理技术对明确诊断有重要价值。
[Abstract]:Objective: to investigate the MSCT findings of adhesive intestinal obstruction and its diagnostic value.Methods: Ct findings of 45 patients with adhesive intestinal obstruction confirmed by clinical diagnosis (n = 15) and surgical pathology (n = 30) were retrospectively analyzed. All patients underwent plain abdominal CT scan and dynamic enhanced CT scan.Results: the main CT findings were as follows: 45 cases of dilatation and collapse or stenosis of intestine, 37 cases of adhesion between intestinal tube and anterior abdominal wall and intestinal canal, 21 cases of adhesive band, 30 cases of "birdmouth" stenosis and 6 cases of "angulation sign" of intestinal duct in obstruction;The mean diameter of proximal obstruction was 25mm, and the degree of obstruction (ratio of dilatation to narrow diameter) was 1.9 / 3.5 / 3.65.01 / 6.5 and 6.5, respectively, in 9 / 1416 and 6 / 6 cases, respectively.The common signs of proximal obstruction included 29 cases of intestinal wall ischemia, 21 cases of abdominal hernia and 20 cases of intestinal volvulus.Conclusion: the MSCT features of adhesive intestinal obstruction have some characteristics and the post-processing technique is of great value in the diagnosis of adhesive intestinal obstruction.
【作者单位】：东莞市塘厦医院放射科;东莞市人民医院放射科;
【分类号】：R574.5;R816.5

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