成人肠套叠MSCT病因学诊断价值

The Diagnostic Value of MSCT in the Etiology of Adult Intussusception

目的探讨MSCT对成人肠套叠病因学诊断价值。方法对40例MSCT诊断成人肠套叠并经手术治疗患者的CT、手术及病理资料进行回顾性分析。结果小肠套叠12例,结肠套叠18例,回盲部肠套叠10例,手术均发现有原发病变。良性病变14例(35.0%),恶性病变26例(65.0%),小肠套叠主要为良性病变(58.3%),结肠套叠主要为恶性肿瘤(88.9%),回盲部肠套叠良恶性病变各占一半。良性病变以息肉、腺瘤和脂肪瘤多见(71.4%),恶性病变以结肠癌和淋巴瘤多见(88.5%)。原发病术前CT检出率77.5%(31/40),术后回顾CT检出率87.5%(35/40)。回顾性分析,CT平扫和增强的原发病检出率分别为73.3%(22/30)和90.9%(20/22)。术后判断CT检出的35例原发病性质,正确31例,错误3例,1例未能判断,准确率88.6%(31/35)。结论 MSCT对成人肠套叠及其病因学诊断具有重要临床价值。

Objective To investigate the diagnostic value of MSCT in the etiology of adult intussusception. Methods CT findings, operation and pathological data of 40 cases with intussusception diagnosed by MSCT and operation were retro- spectively analyzed. Results 12 cases were small intestine intussusception, lg cases were colon intussusception and 10 cases were ileocecum intussusception. All primary lesion were found by operation in 40 cases. In the etiology of these intus- susception, 14 cases（35.0% ） were benign and 26 cases（65.0% ） were malignant. The primary lesions of small intestine intussusception were mainly benign（ 66.7% ）, and of colon intussusception were mostly malignant（94.4% ）. The benign or malignat lesions of ileocecum intussusception were 50.0% respectively. Benign lesions were main polypus, adenoma and li- poma （58.3 % ）. Malignant lesions were most colon carcinoma and lymphoma （88.9%）. The preoperative and retroperative detectability rate of primary lesions with CT werec respectively 77.5% （31/40）and 87.5% （35/40）. These primary lesions with unenhanced or enhanced CT scaning were retrospectively analyzed, detectability rate were 73.3 % （22/30） and 90.9% （20/22） respectively. 35 cases with primary lesions detected by CT were evaluated their nature ,31 cases were correct, 3 ca- ses were incorrect,and 1 case could not be evaluated. The diagnostic accuracy was 88.6% （31/35）. Conclusion MSCT has a great important value in diagnosis of adult intussusception and the etiology.