小肠扭转的螺旋CT诊断

Helical CT Diagnosis of Small Intestine Volvulus

目的:探讨螺旋CT对小肠扭转的诊断价值。方法:对8例经手术证实小肠扭转患者的病例资料进行回顾性分析。1例患者行CT平扫,7例行CT平扫和双期增强扫描,并进行图像后处理,包括容积再现(VR)、多平面重组(MPR)和最大密度投影(MIP)。结果:8例中7例有肠管和血管的漩涡征,5例有鸟喙征,2例见同心圆征,4例显示肠管壁强化减弱、肠壁水肿和腹水。结论:肠管和血管的漩涡征是诊断小肠扭转的特征性征象,同心圆征、肠管强化减弱、肠壁水肿和腹水的出现,则高度提示绞窄性肠梗阻;螺旋CT增强扫描和图像重组可对小肠扭转做出准确的定位和定性诊断。

Objectivet To assess the value of helical CT in diagnosing small intestine volvulus. Methods： The CT findings of 8 cases of small intestine volvulus proved by operation were retrospectively analyzed. Image processing includes volume rendering （VR）,multi-planar reformation （MPR） and maximum intensity projection （MIP）. Results： Among the 8 cases, the main signs ＂whirlpool＂ of intestine and vessels were found in 7 cases,＂beak＂ in 5 cases,＂ target loop＂ in 2 cases and reduced enhancement of intestion wall and ascites in 4 cases. Conclusion.. ＂whirlpool＂ of intestine and vessels is the specific sign for diagnosing small intestine volvulus. The appearance of ＂target loop＂, reduced enhancement of intestion wall, edema and ascites highly demonstrates strangulated intestinal obstruction. The enhanced scan of helical CT and image reconstruction can make a localization and qualitative diagnosis of the small intestine volvulus.