肠系膜上动脉压迫综合征多层螺旋 CT 的诊断价值

The MDCT Diagnostic Value of Superior Mesenteric Artery Compressing Syndrome

目的：探讨多层螺旋CT对肠系膜上动脉压迫综合征（SMACS）的诊断价值。方法：回顾性分析2009年1月至2012年7月我院临床确诊为SMACS，并已行上腹部CT增强扫描的13例患者的影像资料，并选取同期因肝脏或肾脏疾病行CT增强扫描的20例患者的影像资料作为对照组，将动脉期图像进行矢状位MPR重组并测量肠系膜上动脉（ SMA）与腹主动脉（ AA）的夹角及十二指肠水平段通过层面SMA和AA间距。结果：13例SMACS患者SMA与AA的夹角是14．7°～31．6°，平均19．1°±3．4°；十二指肠水平段通过层面SMA与AA的间距为3．1～10．2 mm，平均（7．1±2．0） mm。20例对照组患者SMA与AA的夹角分别为19．5°～60．4°，平均41．5°±9．3°；十二指肠水平段通过层面SMA与AA的间距为7．7～27．1 mm，平均（16．4±4．8）mm。两组间比较，SMA与AA夹角及间距的差异均有统计学意义（ P＜0．001）。结论：多层螺旋CT上腹部增强扫描的动脉期图像及MPR重组能够清楚显示SMA和AA的关系，并能够辅助诊断SMACS。

Objective：To discuss the value of the multi -slice spiral CT in the diagnosis of superior mesenteric artery compressing syndrome .Methods：To retrospectively analyze the imaging data from January 2009 to July 2009 in our hospital .The data of CT images including 13 cases diagnosed as SMACS and 20 cases diagnosed as liver or kidney diseases in the control group .The arterial phase images were reconstructed to the sagittal plane .The anglesand distances between SMA and AA were measured on the sagittaland transverseplane . Results：In the experimental group , the range of angle was 14.7°-31.6°, averaged 19.1°±3.4°, and the range of distance was（3.1-10.2）mm, averaged （7.1 ±2.0）mm.In the control group, these values were 19. 5°-60.4°and （7.7-27.1）mm, averaged 41.5°±9.3°and （16.4 ±4.8）mm.Statistical analysis indicated a significant difference （P〈0.001）.Conclusions：The relationship between SMA and AA can be well demon-strated by multi-slice spiral CT combined multi -planar reconstruction , and which is important for the diagno-sis of SMACS.