多层螺旋CT对成人腹型过敏性紫癜的诊断及疗效评价

发布时间：2018-06-13 04:16

本文选题：紫癜 + 过敏性　；参考：《中国医学影像学杂志》2015年05期

【摘要】：目的分析腹型过敏性紫癜(AAP)的多层螺旋CT(MSCT)表现,探讨MSCT检查在AAP疗效评价中的作用。资料与方法回顾性分析13例经临床和实验室检查确诊为AAP患者的临床和CT检查资料,治疗前均行腹部CT平扫及薄层重建,8例行胃镜检查;治疗后10例行CT平扫复查,4例行胃镜复查。比较治疗前后临床表现和CT征象的差异。结果治疗前13例CT平扫中,2例一段肠管受累,10例多节段肠管受累,1例无阳性发现;8例累及十二指肠、空回肠,5例累及胃;受累肠管壁环形增厚,密度减低,肠腔均匀性狭窄,轮廓模糊不清,呈"双环"征;10例肠管周围见少量渗出,3例腹腔少量积液。CT平扫误诊为急性胰腺炎2例,急性胆囊炎、肠梗阻、腹膜炎各1例。13例患者中,治愈5例,有效8例。患者治疗后四肢皮疹、腹痛、大便潜血、白细胞升高、呕吐、黑便、尿潜血症状较治疗前均得到改善(χ2=5.59~18.33,P0.05、P0.01);10例CT复查多节段肠管水肿、肠管周围渗出改变均显著改善(χ2=10.00、9.52,P0.01),腹腔积液差异无统计学意义(χ2=1.14,P0.05)。结论 AAP的CT表现无特异性,皮疹出现前MSCT诊断困难,结合多节段肠管水肿、渗出等基本CT征象和临床表现有利于本病的诊断,MSCT检查可以有效评价AAP的治疗效果。
[Abstract]:Objective to analyze the MSCT findings of abdominal anaphylactoid purpura (AAP) and to explore the role of MSCT in evaluating the efficacy of AAP. Materials and methods the clinical and CT findings of 13 patients with AAP confirmed by clinical and laboratory examinations were retrospectively analyzed. All patients underwent plain abdominal CT scan and 8 cases of gastroscopy before treatment. After treatment, 10 cases underwent CT plain scan and 4 cases underwent gastroscopy. To compare the difference of clinical manifestations and CT signs before and after treatment. Results before treatment, 13 cases of CT plain scan in 2 cases with one segment of intestinal canal involvement, 10 cases with multiple segment intestinal involvement, 1 case without positive findings, 8 cases involving duodenum, 5 cases of jejunum and ileum involvement of stomach, the wall of the involved intestine was thickened, the density was decreased, and the intestinal lumen was homogeneously narrow, the wall of the involved intestine was thickened, the density was decreased, and the intestinal cavity was homogeneously narrow. In 10 cases with "double ring" sign, 3 cases were misdiagnosed as acute pancreatitis, 1 case with acute cholecystitis, 1 case with intestinal obstruction and 1 case with peritonitis, 5 cases were cured, 3 cases were misdiagnosed as acute pancreatitis, 1 case of acute cholecystitis, 1 case of intestinal obstruction and 1 case of peritonitis. Effective 8 cases. The symptoms of extremities rash, abdominal pain, stool occult blood, leukocytosis, vomiting, black stool and urine occult blood were all improved after treatment (蠂 ~ 2 5.59 ~ 18.33% P 0.05 P 0.05 P 0.01). The changes of peri-intestinal exudation were significantly improved (蠂 ~ 2 / 10.00 / 9.52 / P _ (0.01), but there was no significant difference in peritoneal effusion (蠂 ~ (2) = 1.14 / P ~ (0.05). Conclusion CT findings of AAP are not specific, MSCT is difficult to diagnose before the appearance of skin rash. Combined with basic CT signs and clinical manifestations, such as multilevel intestinal edema and exudation, can effectively evaluate the therapeutic effect of AAP.
【作者单位】：武汉市中心医院核医学科;武汉科技大学附属天佑医院;武汉市第一医院放射科;
【分类号】：R554.6;R816.3

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