螺旋CT对小肠内疝的诊断价值

The value of spiral CT in diagnosis of intestine entocele

目的提高螺旋 CT 对小肠内疝的诊断率。方法对11例经手术证实且术前 CT 资料完整的小肠内疝患者进行回顾性分析,CT 主要后处理方法有多平面重组(MPR)、滑动薄层块最大密度投影(STS-MIP)重组。结果 11例小肠内疝 CT 诊断正确。左侧十二指肠旁内疝表现为胃和胰之间一囊性或囊实性肿块;肠聚集、移位及拥挤、拉伸;肠系膜走行异常,并可见血管充盈增粗,其他肠段移位;疝口、肠梗阻、小肠内疝伴扭转时,还可以显示肠管及附属肠系膜血管的"漩涡征"。结论螺旋 CT 扫描及其后处理技术对小肠内疝具有重要的临床价值。

Objective To elevate the usefulness of spiral CT in diagnosis of intestinal entoeele. Methods The CT findings of 11 cases of intestinal entoeele proved by operation were reviewed. The main reconstruction techniques were MPR （multiple plane reconstruction） and STS-MIP （slip thin slab maximal intensity projection）. Results Eleven cases of intestinal entoceles were all diagnosed accurately before operation. The main sign were left paraduodenal hernia, demonstrated as a saelike mass between stomach and pancreas, clustering, displacing or crowding and elongating of small-bowel loops, engorgement and crowding of the mesenteric vessels with frequent right displacement of the main mesenteric trunk, other bowel displacing. Orificium hernialis were seen with bowel obstruction. When intestinal entoeele accompanying torsion, ＂whirlpool＂ of intestine and mesentery vessels were seen. Conclusion Spiral CT and MPR, STS-MIP techniques have important clinical value to diagnose the intestinal torsion.