多层螺旋CT对老年人小肠梗阻病因的诊断价值

Value of multi-slice spiral CT in the etiological diagnosis of small intestinal obstruction in the elderly

目的评价多层螺旋CT对老年人小肠梗阻病因的诊断价值。方法 119例老年小肠梗阻病例进行了螺旋CT平扫,57例平扫加增强扫描,利用工作站获得重建图像,将CT结果与手术病理对照。结果多层螺旋CT正确诊断梗阻病因116例,其中良性病变98例(包括胆石性梗阻、腹斜疝、腹内疝、闭孔疝、黏连性肠梗阻、粪便纤维素性梗阻、肠套叠、小肠克罗恩病和局限性急性肠炎等),恶性病变18例(包括术后吻合口复发、原发性小肠恶性肿瘤和结肠回盲部恶性肿瘤等),误诊3例。74例小肠梗阻患者经手术证实。结论多层螺旋CT是诊断老年人小肠梗阻病因有效且准确的方法。

Objective To evaluate the value of multi-slice spiral CT(MSCT) in the etilolgical diagnosis of small intestinal obstruction in the elderly. Methods 119 cases of elderly patients with small intestinal obstruction received the detection of MSCT, and 57 cases received plain and enhanced scans. CT datum were transmitted to workstation and reconstruction was performed. CT findings were compared with pathologic findings. Results The reason for obstruction was correctly found by MSCT in 116 cases (116/119, 97.4%). All cases included 98 cases of benign lesions (gallstone obstruction, hernia, adhesive obstruction, intestinal emphysema, phytobezoar, intussusception, Crohn disease, limited acute enteritis) and 18 cases of malignant liesions(anastomotic recurrence,malignant small or large intestinal tumor). 3 cases were misdiagnosed. 74 cases were confirmed by operation. Conclusions MSCT is very effective and accurate in diagnosing the causes of elderly patients with small intestinal obstruction.