不明原因小肠出血数字减影血管造影价值

The value of digital subtraction angiography in diagnosing small intestinal hemorrhage with unknown reasons

目的探讨DSA血管造影对不明原因小肠出血的诊断价值。方法25例小肠出血患者,均经Seldinger法行肠系膜上动脉插管造影。结果显示出血直接征象11例,出血间接征象12例,其中5例同时具有直接征象和间接征象。直接诊断出血18例,阳性率72%。病变性质为:肿瘤性病变10例,其中平滑肌瘤6例,平滑肌肉瘤2例,间质瘤1例,小肠癌1例。梅克尔憩室4例,血管畸形3例,炎症1例。阳性病例与手术病理诊断的符合率为75%,定位诊断符合率100%。结论DSA血管造影对不明原因的小肠出血的定位、定性诊断有肯定的价值。

Objective To discuss the diagnostic value of DSA for unknown reason hemorrhage of small intestine. Methods 25 patients with hemorrhage of small intestine were performed angiography with Seldinger＇s technique through superior mesenteric artery . Results Eleven cases demonstrated direct signs of hemorrhage, 12 cases of indirect signs of hemorrhage and 5 with both of the signs. The positive rate of hemorrhage was 72% including 10 cases of tumor （6 leiomyomas, 2 leiomyosarcomas, 1 interstitial tumor, 1 small intestinal cancer）, 4 cases of Meckel＇s diverticulum, 3 cases of vascular malformation and 1 case of inflammation. The coincidence rate of positive cases with pathology was 75% and the diagnostic accuracy of localization was 100%. Conclusions DSA angiography is very helpful for determining the location and character of unknown reason hemorrhage of small intestine.