摘要
目的:探讨MSCTA技术对小肠扭转的诊断价值。方法:搜集我院2008年10月～2010年6月经手术后病理证实的21例小肠扭转病例。21例患者均行MSCT双期增强并对扫描图像行后处理,由两位经验丰富临床放射科医师观察增强后肠扭转的轴面CT图像,MSCTA图像上观察扭转血管的分布、走行及扭转度数,将MSCT及MSCTA诊断结果与病理结果进行对照,研究MSCTA对肠扭转的诊断价值。结果:CT增强轴位扫描示肠系膜血管呈"漩涡征"、肠管"漩涡征"、肠管"靶征"和"鸟喙征"各2、13、5和2例。仅仅表现为肠梗阻者6例,肠缺血表现者15例,腹腔积液者4例。MSCTA表现:13例肠系膜上动脉(SMA)远端分支扭转及走行异常,且均同时伴随相对应肠系膜上静脉(SMV)远端分支的扭转及走行异常(13/21);2例SMA、SMV主干及分支形态、位置大致正常;2例SMA主干近端扭转合并受累肠系膜上静脉主干扭转;2例SMA与肠系膜上静脉(SMV)走行杂乱,无确切扭转方向;2例SMA与SMV沿Z轴方向呈螺旋形旋转。结论:MSCTA与MSCT双期轴位增强图像相结合可提高肠扭转的诊断符合率。
Objective：To investigate the value of multi-slice CT angiography （MSCTA） in the diagnosis of intestinal volvulus. Methods： Twenty one patients with surgically confirmed intestinal volvulus in the period of 2008-10 -2010-06 were included in this study. All patients received duaLphase contrast enhanced MSCT scanning and image reconstruction was performed with post-processing technique. The axial images acquired by MSCT were studied by 2 senior radiologists, the distribution,course and degree of tortional blood vessels displayed on MSCT angiography were studied at the same time. The MSCT and MSCTA findings were correlated with pathology,and the value of MSCTA in the diagnosis of intesti- nal volvulus was investigated. Results： ＂Whirl sign＂ of bowel, ＂whirl sign＂, ＂target sign＂ and ＂beak sign＂ of mesenteric blood vessels could be assessed on axial enhanced CT images in 2 patients, 13 patients,5 patients and 2 patients respective ly. Only bowel obstruction was shown in 6 patients, bowel ischemia in 15 patients and ascites in 4 patients. The MSCTA manifestations included torsion and abnormal course of distal branches of superior mesenteric artery （SMA） accompanied with torsion and abnormal course of distal branches of superior mesenteric vein （SMV） at the same time in 13 patients, SMA.SMV were normal in 2 patients,torsion of proximal trunk of SMA and SMV in 2 patients,disorderly course of SMA and SMV without a definite tortional direction in 2 patients, spiral rotation along the Z axis of SMA and SMV in 2 patients. Conclusion：The accuracy of the diagnosis of small intestinal volvulus could be improved by MSCTA in combination with ax- ial dual-phase enhanced MSCT.
出处
《放射学实践》
北大核心
2011年第10期1075-1078,共4页
Radiologic Practice
基金
国家自然科学基金项目(30970803)
关键词
肠扭转
体层摄影术
X线计算机
图像处理
计算机辅助
Intestinal volvulus
Tomography,X-ray computed
Image processing, computer assisted
