多层螺旋CT双期扫描对缺血性肠病的诊断价值

发布时间：2018-05-25 04:29

本文选题：缺血性肠病 + 增强双期扫描　；参考：《实用医学杂志》2015年10期

【摘要】：目的:探讨多层螺旋CT双期扫描对缺血性肠病的诊断价值。方法:回顾性分析23例经手术及病理证实的缺血性肠病患者的CT资料。所有患者均行CT平扫、动脉期、门脉期扫描及血管重建。结果:23例肠缺血患者中,肠系膜上动脉主干闭塞2例,分支闭塞1例,主干及部分分支均闭塞4例,肠系膜上动脉狭窄、血栓形成5例,肠系膜上动脉夹层形成2例,肠系膜上动脉瘤1例,肠系膜下动脉狭窄1例,肠系膜上静脉血栓形成6例,心功能不全患者1例。间接征象包括缺血肠管表现节段性扩张积液11例,弥漫性扩张8例;肠壁增厚15例,4例肠壁变薄,4例无明显变化。增强扫描8例肠管强化显著,7例增厚肠管强化减轻,2例无明显强化。2例回肠扩张肠壁内积气、腹腔积气。CT诊断缺血性肠病敏感性为95%,特异性为93%。结论:多层螺旋CT双期扫描对缺血性肠病的诊断具有重要作用。
[Abstract]:Objective: to evaluate the diagnostic value of multi-slice spiral CT dual-phase scan in ischemic bowel disease. Methods: Ct findings of 23 patients with ischemic bowel disease confirmed by operation and pathology were retrospectively analyzed. All patients underwent plain CT scan, arterial phase, portal phase scan and vascular reconstruction. Results among 23 cases of intestinal ischemia, 2 cases had superior mesenteric artery occlusion, 1 case had branch occlusion, 4 cases had main and partial branch occlusion, 5 cases had superior mesenteric artery stenosis, 5 cases had thrombosis, 2 cases had dissection of superior mesenteric artery. There were 1 case of superior mesenteric artery aneurysm, 1 case of inferior mesenteric artery stenosis, 6 cases of superior mesenteric vein thrombosis and 1 case of cardiac insufficiency. Indirect signs included segmental dilatation in 11 cases, diffuse dilatation in 8 cases, thickening of intestinal wall in 15 cases and thinning of intestinal wall in 4 cases. Enhanced scanning was performed in 8 cases with significant enhancement of intestinal duct and in 7 cases with thickening of intestinal canal. In 2 cases, there was no obvious enhancement in 2 cases of ileal dilatation. The sensitivity and specificity of CT in diagnosis of ischemic bowel disease were 95% and 933% respectively, while abdominal cavity accumulation of gas was 95% and specificity was 933%. Conclusion: multi-slice spiral CT dual-phase scan is important in the diagnosis of ischemic bowel disease.
【作者单位】：广东省佛山市第一人民医院CT室;
【基金】：佛山市医学类科技攻关项目(编号:2014AB00314)
【分类号】：R574;R816.5

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