肠缺血中肠系膜及其血管的MDCT表现

目的探讨肠缺血中肠系膜及其血管的多层螺旋CT表现与诊断价值。方法回顾性分析28例肠缺血患者的肠系膜及其血管的多层螺旋CT平扫和增强表现,所有病例经手术、临床病理或DSA造影证实。结果CT表现:肠系膜水肿18例,肠系膜积气2例,肠系膜血管走行异常7例,肠系膜血管充盈缺损5例,肠系膜主干血管增粗2例,节段性肠系膜小血管充血21例,节段性肠系膜小血管缺血7例,肠系膜静脉积气2例。另可见其他表现:肠壁增厚25例,肠管扩张26例,肠腔大量积液23例,肠壁异常强化25例,肠管形态异常10例,肠壁积气3例,腹水和气腹12例。结论肠系膜及其血管的CT改变是诊断肠缺血的重要依据,CT检查具有重要的价值,并可提示肠缺血的原因。

Objective To investigate the performance and diagnosis value of MDCT of the mesentery and its blood vessels in the intestinal ischemia. Methods The performance of MDCT of the mesentery and its blood vessels retrospectively analyzed in 28 patients with intestinal ischemia. All were proved by surgery, clinical pathology or DSA. Results CT shows 18 cases of mesenteric edema, 2 cases of mesenteric pneumatosis, 7 cases of mesenteric vascular anomalies, 5 cases of mesenteric vascular were filling defect, 2 cases of the trunk of the mesenteric vascular were thickening, 21 cases of segmental mesenteric small blood vessels hyperemia, 7 cases of segmental mesenteric small blood vessels ischemia and 2 cases of the mesenteric venous accumulation of gas. Other manifestations can be seen： 25 cases of bowel wall were thickening, 26 cases of intestinal expansion, 23 cases of intestinal had a large number of hydrops, 25 cases of bowel wall abnormal enhancement, 10 cases of bowel morphologic abnormality, 3 cases of pneumatosis intestinalis, 12 cases of abdominal ascites or pneumoperitoneum. Conclusion The performance of MDCT of the mesentery and its blood vessels for the diagnosis of the intestinal ischemia is an important evidence, CT examination is an important value and can revealed the reasons of the intestinal ischemia.