多层螺旋CT对肠扭转的诊断价值

Diagnostic value of multi-slice spiral CT on intestinal volvulus

目的总结肠扭转的CT表现,探讨多层螺旋CT(MSCT)对肠扭转的诊断价值。方法回顾性分析11例肠扭转患者的CT检查资料和临床资料,所有患者均行CT平扫和增强扫描,并将数据传送到ADW 4.2工作站,进行图像后处理。结果 CT平扫显示肠管不同程度扩张、胀气,内见长短不一的液气平面影,肠壁和肠系膜增厚,密度减低,增强扫描病变肠段强化减弱;9例小肠扭转患者中,3例可见"U"形征,8例可见"漩涡"征;4例见"鸟喙"征,3例见"靶环"征;2例MPR图像显示肠系膜血管扭曲,3例伴有腹腔积液;2例乙状结肠扭转患者均可见"鸟喙"征,其中1例可见"S"征,另1例可见"U"形征。结论肠扭转的MSCT表现有一定特征,MSCT分辨率高,扫描速度快,应用图像后处理技术可多方位、多角度观察病灶,对肠扭转的诊断具有一定价值。

Objective To summarize the CT manifestation of intestinal volvulus and investigate the diagnostic value of multi-slice spiral CT（MSCT） on intestinal volvulus. Methods CT examination data and clinical data of 11 patients with intestinal volvulus was analyzed retrospectively,all the patients underwent CT plain scan and enhanced scan,and the datas was sented the ADW 4.2 workstation for image postprocessing. Results Different degree of intestinal dilatation, flatulence and liquid-gas surface were showed on CT,thickening of the intestinal wall and mesentery,lower density,the intestinal segment lesions with reduced enhancement.Among the 9 cases of small bowel volvulus,the signs of ＂U＂ shape configuration were found in 3 cases,＂whirlpool＂ in 8 cases;＂beak＂ in 4 cases;＂target loop＂ in 3 cases;Twisted mesenter- ic vascular of MPR image were displayed in 2 cases,3 cases with seroperitoneum.＂Beak＂ sign was found in 2 patients with sigmoid colon volvulus,and 1 case with ＂S＂ sign,the other with ＂U＂ shape sign. Conclusion Intestinal volvulus has characteristic features on MSCT images,MSCT has the advantages of high resolution and fast scanning speed,it can ob- serve the lesions in multi-direction and multi angle to use image postprocessing,it has the value in diagnosing intestinal volvulus.