血管源性急腹症多层螺旋CT诊断价值

The value of multislice spiral CT in the diagnosis of angiogenic acute abdomen

目的探讨以急性腹痛为主要表现的血管源性疾病的多层螺旋CT表现及诊断价值。方法回顾性分析经临床或手术确诊的35例血管源性急腹症的CT表现,包括平扫和增强扫描及利用多种图像后处理技术重建的图像,如多平面重建法(MPR)、曲面重建法(CPR)、最大密度投影法(MIP)、容积成像法(VR)、表面遮盖法(SSD)进行血管成像。结果肠系膜上静脉、门静脉及脾静脉血栓13例,夹层动脉瘤10例,肠系膜扭转伴肠梗阻3例,腹部动脉瘤3例,外伤致肠系膜血肿3例,腹部动脉血栓3例。结论多层螺旋CT平扫联合增强扫描,结合多种图像后处理技术能快速显示血管源性急腹症的病因、部位及范围,可作为首选的影像学检查方法。

Objective To explore the imaging findings of angiogenic acute abdomen（AAA） on multislice spiral CT（MSCT） scan and to evaluate diagnostic significance.Methods Thirty-five patients with AAA proved clinically and pathologically underwent plain CT scanning and contrast enhanced scanning of the abdomen.Subsequently,the source images were transferred into the workstation and postprocessed by using MPR,CPR,MIP,VR and SSD.The CT findings and pathogenetic causes of AAA were retrospectively analyzed in all patients.Results The imaging of MSCT scan and its reconstruction showed the causes resulted in AAA of 35 cases,including 13 thrombi of superior mesenteric vein,portal vein and splenic vein,10 dissecting aneurysm,3 mesenteric distortion with intestinal obstruction,3 abdominal aneurysm,3 tramatic mesenteric hematomas and 3 thrombi of abdominal artery.Conclusion MSCT combined with its reconstruction technigues can clearly visualize the cause,location and extent of AAA so that it can be used as the preferred method.