螺旋CT在机械性肠梗阻诊断中的作用

Value of Spiral CT in the Diagnosis of Mechanical Intestinal Obstruction

目的：探讨螺旋CT在机械性肠梗阻诊断中的作用。方法：回顾性分析我院2002～2005年经CT诊断并经手术证实的48例肠梗阻病例。所有患者均采用全身螺旋CT机做CT平扫，其中6例另行增强CT扫描。结果：所有48例肠梗阻病例的CT诊断结果与临床手术结果相符。①在本组病例中，CT扫描显示肠梗阻部位（小肠梗阻29例，结肠梗阻19例）；肠梗阻原因（腹壁疝13例，肿瘤19例，肠粘连14例，肠套叠3例，胆石性肠梗阻2例）；肠梗阻性质（单纯性肠梗阻41例，绞窄性肠梗阻7例）。②CT扫描不仅显示肠梗阻时肠道的扩张及肠腔内的气液平面，而且清晰地显示肠梗阻时肠壁、肠系膜的情况、闭襻的形成以及肠梗阻是否伴有出血及腹水等征象。结论：CT检查可以判定有无肠梗阻，确定肠梗阻的部位及肠梗阻的原因，以及是否为绞窄性肠梗阻，CT是机械性肠梗阻诊断的有效方法。

Objective： To investigate the value of spiral CT in the diagnosis of mechanical intestinal obstruction. Methods：48 cases of surgery proved intestinal obstruction were analyzed retrospectively. All cases underwent emergency plain CT scanning. Among them,6 cases had contrast enhanced CT, Results of CT and surgery were correlated with pathology findings. Results：All CT diagnosis were in concordance with the surgical findings. （1） CT accurately displayed the site （small intestine, n = 29 ; colon n = 19） ; the cause （abdominal wall hernia, n = 13 ; neoplasm n = 19 ; adhesions, n = 14 ; intussusception, n= 3 ;gallstone ileus, n= 2） of intestinal obstruction and the existence of strangulation （n= 7）. （2） CT revealed both direct signs （dilatation and air-fluid level within intestine） and indirect signs （status of intestinal wall, mesentery, close-loop formation, hemorrhage and ascites） of intestinal obstruction. Conclusion： CT scanning is helpful in detecting the existence, as well as the site, the cause of intestinal obstruction. Furthermore, whether there is intestinal strangulation can also be revealed. Thus,CT provides important information in the diagnosis of mechanical intestinal obstruction.