多层螺旋CT小肠造影增强扫描的临床应用研究

The Clinical Applicative Study of Multi-Slice Spiral CT Enterography with Enhancement

目的分析口服大剂量2.5%等渗甘露醇在多层螺旋CT小肠造影(multislice CTEnterog-raphy,MSCTE)增强扫描中的表现。方法选取30例正常体检者,扫描前30min内分3次口服浓度2.5%的甘露醇2000ml,并肌内注射20mg山莨菪碱(654-2)。然后静脉高压注入优维显100ml后行螺旋CT增强扫描,通过获取多期(20、40、60、120s)横断面及多平面重建(multiplanar reformation,MPR)图像,分别测量小肠各段(十二指肠、空肠、回肠)肠壁与肠腔的CT值以及小肠系膜CT值,进行对比分析。结果小肠充盈均匀,肠腔与肠壁密度对比度好。同一期相中,小肠各段CT值无明显差异(P>0.05);小肠系膜CT值在各期相中无明显差异(P>0.05);小肠肠壁CT值在60s接近峰值,肠腔密度与肠壁密度对比度最佳。结论口服大剂量等渗甘露醇在MSCTE增强扫描中能较好地显示肠壁细微结构及较好地反映肠壁密度,于静脉早期(60S)显示肠壁增强效果最好。

Objective To analyse the finding of Multislice CT Enterography（ Muhislice CT Enterography, MSCTE） with enhancement after large dose isosmotic mannitol （2. 5 % ） was oral administered . Methods 30 example with normal physical was taken 2000 ml mannitol （2. 5% ） divides 3 times before the CT scan 30min, and 20 mg anisodamine（654-2） was injected into muscular. The 100ml ultravist was poured into vein with high pressure before the spiral CT enhancement scanning, The multi-times （20 s, 40 s, 60 s, 120 s） images were gained through transverse plane and multiplanar reformation, （ MPR）, the CT value of the intsetine wall and cavity of the small intestine each section （duodenum, jejunum, ileum） was tested through contrast a- nalysis. Results The small intestine full is even, density contrast of the enteric cavity and the intestines wall is good. The CT value of the small intestine each section not obvious difference identical time（ P 〉 0.05 ） ; The CT value of small mesentery in various time not obvious difference （ P 〉 0. 05 ） ; The CT value of intestines wall close peak in the 60 s, the density contrast of the enteric cavity and wall is best. Conclusion Isotonia mannitol （2. 5% ）was taken into intestine before multislice CT Enterography with enhancement, slight structure of the intestines wall was demonstrated well and better reflect the density of the intestinal wall, in the vein of early （60 s） showed the best effect to enhance the intestinal wall.