多层螺旋CT对小肠Meckel’s憩室的诊断价值

The value of multi-detectors CT in diagnosing small intestinal meckel's diverticulum

目的探讨多层螺旋CT对小肠Meckel’s憩室的诊断价值。方法搜集经手术及病理证实的7例小肠Meckel’s憩室患者的临床与CT检查资料,回顾性分析检查方法对诊断结果的影响。结果 7例患者术前均做了多层螺旋CT增强扫描,其中3例做了肠道准备并行三维重建者,明确诊断为Meckel’s憩室2例,其中1例表现为回肠壁上的不规则盲管状含气突起,其壁较厚,增强扫描时显著强化,另1例表现为肠壁局限性向下突起的含液指状憩室,其内可见小结节状软组织影,增强扫描憩室壁及憩室内小结节均明显强化。3例未做肠道准备也未行三维重建者及1例未做肠道准备但行三维重建者均未发现憩室。结论多层螺旋CT增强扫描及三维重建图像后处理可全面、直观地显示Meckel’s憩室的位置、形态及其与邻近肠管的关系,对该病的诊断有很大的帮助,CT扫描前充分的肠道准备则是其必要条件。

Objective To investigate the value of multi-detectors CT in diagnosing small intestinal Meckel＇s diverticulum. Methods The clinical and CT datum of 7 patients with surgically and pathologically confirmed Meckel＇s diverticulum were collected, and the effect of examination method on diagnosis result were analyzed retrospectively. Results All 7 patients underwent enhanced multi-detectors CT scanning. 2 of 3 patients that had performed bowel preparation and been analyzed witla 3D-reconstruction were definitely diagnosed as Meckel＇s diverticulum. In one of them, a blind-ending gas-filled strue ture in continuity with ileum was seen. It＇s thickened wall was enhanced significantly. In another, a fluid-filled thumb- shaped enhanced diverticulum was found, in which there was a small enhanced node. The diverticulum was not found in 3 patients that neither had performed bowel preparation nor been analyzed with 3I）-reconstruction and 1 patient that hadn＇t performed bowel preparation but had been analyzed with 3D-reconstruction. Conclusion Enhanced multi-detectors CT scanning and 31〉reconstruction are helpful in diagnosing Meckel＇s diverticulum because they can entirely and directly dis- play its location, shape and relationship with the adjacent intestines, and adequate bowel preparation before CT scanning is necessary.