多层螺旋CT对小肠出血的诊断价值

The diagnostic value of multi-slice spiral CT in intestinal hemorrhage

目的:探讨多层螺旋CT(MSCT)对小肠出血的诊断价值。方法:对13例临床可疑小肠出血患者行MSCT检查,采用7.5mm层厚平扫后行动脉期、静脉期增强扫描,并结合MSCT多模式重组如多平面重建(MPR)、最大密度投影(MIP)图像分析诊断,大部分病例经手术或临床随访证实,部分与DSA对照。结果:13例临床拟诊小肠出血患者,MSCT明确诊断出血部位11例,2例MSCT未发现出血灶及肠道异常。13例中5例行DSA,4例显示出血灶,1例表现阴性。MSCT出血显示率84.6%(11/13)。CT显示出血部位:十二指肠出血3例,空肠出血4例,回肠出血4例,其中溃疡2例,肿瘤3例,炎症4例,血管畸形1例,憩室1例。结论:利用多层螺旋CT双期增强扫描结合后处理技术能提高小肠出血性疾病诊断的准确性,具有重要的诊断价值及临床应用价值。

Objective:To explore the diagnostic value of multi-slice spiral CT(MSCT)in intestinal hemorrhage.Methods:13 patients with clinically suspected intestinal hemorrhage were all examined using MSCT.The patients were initially performed with 7.5 mm slice thickness plain scans and then Dual-phase enhanced scan using multi-modal reorganization such as multiplanar reconstruction(MPR),maximum intensity projection(MIP) image,Most cases were confirmed by surgery or clinical follow-up.The other cases were confirmed by DSA.Results:In 13 clinically suspected cases of intestinal hemorrhage,hemorrhagic lesions were confirmed in 11 cases.In these13 cases,DSA was performed in 5 cases with a result of 4 positive and 1 negative.There were 2 cases in which no signs of hemorrhage were found by MSCT.Positive detection rate of MSCT in the diagnosis of intestinal hemorrhge was 84.6%(11/13).Sites of hemorrhage depicted by MSCT were as follows: duodenal hemorrhage(n=3),jejunal hemorrhage(n=4) and ileal hemorrhgge(n=4),while,the pathological nature of the hemorrhagic lesions was ulcer in 2 cases,tumor in 3 cases,inflammation in 4 cases,vascular malformation in 1 case,diverticulitis in 1 case.Conclusion:MSCT with dual-phase enhanced scan and relative reconstruction techniques plays an important role in diagnosis,clinical application of intestinal hemorrhage because it could improve the accuracy of diagnosis.