64层螺旋CT在肠道急腹症病因诊断中的价值

Evaluation of 64-slice spiral CT in the cause diagnosis of acute abdomen of intestinal tract

目的：探讨64层螺旋CT在肠道急腹症病因诊断中价值。方法：对46例经手术或临床证实的肠道急腹症病例资料行64层螺旋CT平扫加增强扫描,并进行回顾性分析。主要重组方法为多平面重组（MPR）、最大密度投影（MIP）及容积再现（VR）。结果：46例病例中,肠道肿瘤22例、肠道炎性病变11例、憩室5例、淋巴瘤2例、肠系膜上静脉血栓1例、肠坏死1例、麻痹性肠梗阻伴全内脏转位1例、单纯性肠扭转1例、腹壁疝及闭孔疝各1例;其中64层螺旋CT准确诊断（定位定性）40例,诊断符合率87.0%,4例结肠癌误诊为炎性病变,漏诊脂肪瘤及肠穿孔各1例。结论：64层螺旋CT扫描及重组图像对肠道病变显示直观、准确,对肠道急腹症的病因诊断具有重要的诊断价值。

Objective：To assess the value of 64-slice spiral CT in the cause diagnosis of intestinal tract acute abdomen.Methods：Forty-six patients with intestinal tract acute abdomen were examined using unenhanced CT and contrast-enhanced CT scans.CT findings were correlated with pathological and follow-up results in order to evaluate the accuracy of CT in the diagnosis of intestinal tract acute abdomen.The major methods of reconstruction were MPR,MIP and VR.Results：The results of CT and surgical findings were consistent in 40 （87.0%） of 46 cases with intestinal tract acute abdomen,including neoplasm 22 cases,inflammation 11 cases,diverticulum 5 cases,lymphoma 2 cases,superior mesenteric vein thrombosis 1 case,intestinal necrosis 1 case,paralytic ileus with transposition of the entire visceral 1 case,simple volvulus 1 case,abdominal wall hernia 1 case and obturator henia 1 case.Four cases of colon cancer were misdiagnosed as inflammatory lesions.Lipoma and intestinal perforation were missed for one case each.Conclusion：Three-dimensional reformated images of 64-slice spiral CT can clearly and correctly demonstrate the lesions of intestinal tract.It is valuable in the cause diagnosis of intestinal tract acute abdomen.