多层螺旋CT诊断成人肠套叠的价值

发布时间：2018-05-12 20:27

本文选题：肠套叠 + 体层摄影术　；参考：《中国医学影像学杂志》2015年07期

【摘要】：目的成人肠套叠较少见,且临床症状不典型,较易误诊,本研究旨在探讨成人肠套叠的多层螺旋CT(MSCT)征象,以提高该病的诊断水平。资料与方法回顾性分析经手术病理确诊为成人肠套叠的60例患者的临床和影像资料,观察肠套叠套头部病变、套鞘部肠管、折返部肠管、套入部肠管及卷入的肠系膜脂肪、血管等的CT表现。结果直接征象:套叠头部区肿块的靶征60例,其中单靶征44例、双靶征16例,外形呈肾形征39例、不规则状肿块21例;体部出现双肠管征22例;尾部出现彗星尾征15例,不同方向的"山"字征25例。间接征象:60例均有不同程度的套叠区域肠壁增厚,肠腔内见肠系膜脂肪及血管影45例。伴有肿块旁肠系膜及腹膜后有淋巴结肿大12例,腹水5例,转移瘤7例,其中肝脏转移4例,骨盆成骨性转移2例,多脏器转移1例。合并肾结石1例、输尿管结石3例。结论成人肠套叠具有特征性CT表现,尾部呈现不同方向的"山"字征为特征之一,CT检查对成人肠套叠的临床诊断、治疗有重要指导作用。
[Abstract]:Objective: adult intussusception is rare, and its clinical symptoms are atypical, so it is easy to misdiagnose. The purpose of this study was to investigate the MSCT findings of adult intussusception and to improve the diagnostic level of the disease. Materials and methods the clinical and imaging data of 60 cases of adult intussusception confirmed by operation and pathology were analyzed retrospectively. The pathological changes of the head of intussusception, the sheath of the intestine, the reentrant intestinal canal, the entrapment of the intestinal canal and the mesenteric fat involved in the intussusception were observed. Ct findings of blood vessels and so on. Results the direct signs were as follows: target sign in 60 cases, single target sign in 44 cases, double target sign in 16 cases, renal shape sign in 39 cases, irregular mass in 21 cases, double bowel sign in 22 cases, comet tail sign in 15 cases. There are 25 cases of "mountain" sign in different directions. Indirect signs were found in 60 cases with different degree of thickening of intestinal wall in intussusception area, and mesenteric fat and vascular shadow were found in 45 cases. There were 12 cases of lymph node enlargement, 5 cases of ascites, 7 cases of metastatic tumor, including 4 cases of hepatic metastasis, 2 cases of pelvic osteogenic metastasis and 1 case of multiple organ metastasis. Renal calculi were found in 1 case and ureteral calculi in 3 cases. Conclusion CT findings of adult intussusception have characteristic CT features. One of the features of "Shan" sign in different directions of tail is that CT examination plays an important guiding role in the clinical diagnosis and treatment of adult intussusception.
【作者单位】：广西壮族自治区柳州市工人医院(广西医科大学第四附属医院)放射科;广西壮族自治区柳州市工人医院(广西医科大学第四附属医院)普外科;
【分类号】：R574.3;R816.5

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