成人中肠旋转不良的CT诊断和鉴别诊断

The CT Diagnosis and Differential Diagnosis of the Midgut Malrotation in Adults

目的通过回顾分析15例成人中肠旋转不良病人的CT影像资料,以期能提高放射科医生对该病的正确认识、减少误诊。方法回顾性分析15例成人中肠旋转不良病人的CT影像资料,并归纳总结其CT影像特点及鉴别诊断。结果15例患者中11例出现“漩涡征”,9例出现肠系膜动静脉血管“换位征”,4例出现回盲部异位,1例出现十二指肠异位,1例出现横结肠异位;其中1例合并异位阑尾炎,1例合并小肠梗阻,1例合并胆总管轻度低位梗阻改变。结论成人中肠旋转不良患者的CT表现可能有一些较特异的征像,如“漩涡征”和肠系膜血管“换位征”等,但还需密切结合临床仔细分析,鉴别其他疾病,以提高其影像诊断的准确率、减少误诊。

Objective To analyze the CT imaging features of 15 patients with Midgut malrotation,in order to improve the accuracy of imaging diagnosis and reduce misdiagnosis.Methods The CT imaging data of 15 patients with Midgut malrotation were retrospectively analyzed and summarized.Results Among the 15 patients,11 cases showed“Vortex sign”,9 cases showed“Transposition sign”of the arteriovenous position of mesentery,4 cases showed ileocecal ectopia,1 case showed duodenum ectopia,1 case showed transverse colon ectopia;there were 1 case complicated with ectopic appendicitis,1 case complicated with smallbowel obstruction and 1 case complicated with mild low level obstruction of common bile duct.Conclusion The CT findings of the Midgut malrotation in adults may have some specific certain specificity,such as“Vortex sign”and the“Transposition sign”of the arteriovenous position of mesentery,closely combined with clinical symptoms,and a careful analysis of the imaging manifestations,can improve the accuracy of imaging diagnosis and reduce misdiagnosis.