粘连性小肠梗阻肠系膜血管CTA表现:基于治愈方式的分析

CT Angiographic Findings of Mesenteric Vasculature in Patients with Adhesive Small Bowel Obstruction: Analysis Based on Choice of Cure

目的初步分析粘连性小肠梗阻患者肠系膜血管的CTA表现。资料与方法回顾性分析12例粘连性小肠梗阻的肠系膜血管CTA图像。依据治愈方式分为非手术治愈组和手术治愈组,分析内容包括肠系膜血管有无聚集、移位、狭窄、扩张、充盈缺损。结果非手术治愈的9例中,3例见多支空肠或回肠血管呈束状聚集,1例见回结肠动静脉顺时针移位,1例见回结肠动脉逆时针移位,2例见多支空肠血管逆时针移位,2例未见明显异常走行血管。经手术治愈的3例中,1例见空肠动脉右移,末段回肠动脉略聚集;1例仅见末段回肠血管聚集,1例见多支空肠血管逆时针移位。所有病例均未见肠系膜血管的狭窄、扩张及充盈缺损。结论肠系膜血管聚集、移位为粘连性小肠梗阻主要的CTA表现,少数患者CTA无异常或呈现既往手术后改变。经手术治愈的粘连性小肠梗阻,仅见轻微的肠系膜血管异常。

Objective To preliminarily describe CT angiography （CTA） findings of mesenteric vaseulature in patients with adhesive small bowel obstruction （SBO）. Materials and Methods CTA images of mesenteric vasculature in 12 patients with adhesive SBO were retrospectively reviewed. All patients were classified as either non-operation-cured or operation-cured. Analysis included presence or absence of convergence ,displacement, stenosis ,dilation and filling defect of mesenteric vasculature. Results For 9 non-operation-cured patients, convergence of multiple jejunal or ileal vasculatures were seen in 3, with clockwise and counterclockwise displacement of ileocolic vasculature in 1, respectively, counterclockwise displacement of multiple jejunal vasculatures in 2, and no abnormality in 2. For 3 operation-cured patients, right displacement of a jejunal artery and mild convergence of distal ileal arteries were seen in 1, with convergence of distal ileal arteries in 1, and counterclockwise displacement of multiple jejunal vasculatures in 1. No stenosis, diiation and filling defect of mesenteric vasculature was seen in all cases. Conclusion Convergence and displacement of mesenterie vasculature were the main CTA findings in patients with adhesive SBO, A few cases had no abnormality or postoperative change due to previous surgery. Only mild abnormality of mesenteric vasculature was seen in operation-cured adhesive SBO.