CT仿真结肠镜及肠系膜血管CTA成像在乙状结肠扭转的诊断价值

发布时间：2018-05-04 22:25

本文选题：乙状结肠疾病 + 体层摄影术　；参考：《中国临床医学影像杂志》2017年09期

【摘要】：目的:探讨CT仿真结肠镜及肠系膜血管CTA成像在乙状结肠扭转的诊断价值。方法:回顾性分析12例经MSCT检查并且手术外科证实的乙状结肠扭转患者的影像资料,运用CT仿真内窥镜(CTVE)、容积再现(VR)、最大密度投影(MIP)及多平面重组(MRP)等后处理重建技术显示肠管及肠系膜血管。结果:12例CTVE显示乙状结肠不同程度的积气扩张,11例呈倒"U"形,1例呈"C"形。CTVE显示扭转闭袢的马蹄形肠曲敏感度91.7%(11/12)要高于腹部平片41.6%(5/12),两者统计学上有差异(P0.05)。8例CTA显示乙状结肠动脉走行位置异常,6例近段扭转,2例结构紊乱;MIP显示2例结肠动脉弓显影稀疏变淡,手术证实肠壁缺血。结论:MSCT结合CT仿真结肠镜及肠系膜血管CTA成像可以直观地显示乙状结肠扭转闭袢的肠曲形态,对判断是否合并肠缺血坏死有一定的诊断价值。
[Abstract]:Objective: to evaluate the diagnostic value of CT virtual colonoscopy and mesenteric CTA imaging in sigmoid volvulus. Methods: the imaging data of 12 patients with sigmoid volvulus proved surgically by MSCT were analyzed retrospectively. Ct virtual endoscopy, volumetric reconstruction, maximum density projection (MIP) and multiplanar recombination MRP (MRP) were used to display mesenteric and mesenteric vessels. Results 12 cases of CTVE showed different degree of dilatation of sigmoid colon. 11 cases showed inverted "U" shape. 1 case showed "C" shape. CTVE showed sensitivity of 91.7% to 11 / 12 of horseshoe intestinal curvature in torsion closed loop. It was higher than 41.6% / 512% of abdominal plain film. There was a statistical difference between the two cases (P0.05.8 cases) CTA showed that the sensitivity of horseshoe intestinal curvature in torsion closed loop was higher than that of abdominal plain film (P 0.05.8). Abnormal position of sigmoid colonic artery in 6 cases with proximal torsion 2 cases with structural disorder MIP showed 2 cases with sparse development of colonic artery arch. Intestinal wall ischemia was confirmed by surgery. Conclusion CTA imaging combined with CT virtual colonoscopy and mesenteric vascular CTA can visualize the shape of the closed loop of sigmoid volvulus and has certain diagnostic value in the diagnosis of intestinal ischemic necrosis.
【作者单位】：广东省佛山市顺德区第二人民医院放射科;广东省佛山市顺德区第一人民医院放射科;广东省中医院放射科;
【分类号】：R656.1;R816.5

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