成人肠套叠临床及CT特点探讨

Adult Intussusception: Clinical Features and CT Appearances

目的：探讨成人肠套叠的临床及CT表现。方法：收集本院2010~2011年经临床确认的肠套叠患者24例,回顾分析其临床及CT资料。结果：最常见的临床症状为腹痛、恶心、呕吐,其次表现为黑便、体质量减轻、发热、便秘。24例患者中小肠套叠15例,结肠套叠7例,回结肠套叠2例。16例呈慢性病史。CT直接征象表现为＂同心圆＂征24例,＂彗星尾＂征8例＂,肾形肿块＂5例。非肿瘤性病变套叠肠管的长度和套入部肠管的直径分别为55.31±10.19 mm、30.06±2.56 mm,肿瘤性病变分别为120.46±17.42 mm、44.55±5.55 mm。小肠肿瘤性病变套叠肠管的长度和套入部肠管的直径分别为94.08±14.72 mm、36.75±3.25 mm,结肠分别为95.15±29.89 mm、43.35±5.61 mm。结论：成人肠套叠临床症状不典型,CT扫描对发现原发病灶意义较大。

Objective： To investigate The clinical features and value of mult-islice spiral CT（MSCT）with multi-planar reformation（MPR）in the diagnoisis of adult intussusception.Methods： The clinical features and CT imaging findings of twenty-four cases with clinical proven adult intussusception included 14 males and 10females whose average age was 46.3（24～71）were retrospectively reviewed.Results： The most common symptoms of intussusceptions were abdominal pain,nausea and vomiting and less frequently melena,weight loss,fever and constipation.Symptoms were in 16 cases of long duration.All of the intussusceptions were classified as follows： small intestine small intestine type（15 cases）,ileum-ascending colon type（2 cases） and colon-colon type（7 cases）.On CT scanning＂,concentric circle sign＂（24 cases）,＂kidney-like tumor sign＂（5 cases）and ＂comet tail sign＂（8cases）were demonstrated.The length of intussusceptions with a nonneoplastic lead point was 55.31±10.19 mm,and the diameter was 30.06±2.56mm.The length of intussusceptions with a neoplastic lead point was 120.46±17.42 mm,and the diameter was 44.55±5.55 mm.The length of enteric intussusceptions with a nonneoplastic lead point was 94.08±14.72 mm,and the diameter was 36.75±3.25 mm.The length of colonic intussusceptions with a nonneoplastic lead point was 95.15±29.89 mm,and the diameter was 43.35±5.61 mm.Conclusion： The clinical manifestations of adult intussusception are not typical,being easily misdiagnosed,while CT scans may help to make early diagnosis,especially the detection of causative lead point.