肠系膜血管缺血所致肠坏死CT诊断

CT diagnosis of intestinal necrosis caused by mesenteric ischemia

肠系膜血管缺血所致肠坏死病情重、进展快,及早发现肠坏死极其重要,CT增强扫描是诊断肠坏死的最主要的有效方法。CT增强扫描动脉期图像重点是观察肠系膜动脉血管有无栓塞,观察肠管的动脉血供情况;门静脉期扫描可以显示邻近肠管的肠系膜静脉血管。肠坏死时肠壁肿胀、增厚、边缘模糊、毛糙;缺血时强化程度减低;肠壁坏死时无强化,严重时坏死肠管浆膜面不连续,黏膜下可见小气泡影,为肠壁坏死的特征性征象。

Acute mesenteric ischemia can cause a severe and rapid-progressed necrosis of bowel. Therefore，early detection of acute mesenteric ischemia is extremely important. Enhanced CT is the most effective method. It could depict embolization of superior mesenteric artery at arterial phase，and superior mesenteric vein at portal phase. The bowel necrosis performs as swelling，thickening and attenuating of the relevant intestinal wall，even discontinuity of the serosa at severe condition. The characteristic sign is small air-bubbles under the mucosa.