MSCT及MPR在儿童继发性肠套叠诊断中的应用

The diagnostic value of MSCT with MPR in children with secondary intussusception

目的探讨多层螺旋CT(MSCT)及多平面重组(MPR)重建技术在儿童继发性肠套叠诊断中的征象与应用价值。方法回顾分析经手术和病理证实16例儿童继发性肠套叠的MSCT表现。结果肠套叠类型:回-回型6例,回-回-结型1例,回-结型9例。影像表现:所有16例MSCT横轴面图像结合MPR图像均显示"靶征"或"同心圆征","彗星尾征"伴"肾形肿块征"12例,"血管卷入征"8例;MSCT检出原发病灶12例。病理结果:肠壁及肠系膜淋巴结肿大6例,肠重复畸形2例,淋巴瘤1例,小肠息肉3例,克罗恩病1例,回肠末端狭窄2例,腹部手术后应激性肠套1例。结论MSCT薄层图像对儿童继发性肠套叠及其原发病变有较高的检出及定性能力,结合MPR图像后处理技术,能更好地显示肠套叠的套入部位及诱发病因,对儿童继发性肠套叠的诊断、治疗有重要的指导作用。

Objective To discuss the clinical value and imaging signs of multi-slice spiral CT （MSCT） with multi-planar reformation （M PR） in the diagnosis of secondary intussusception among children .Methods We retrospectively analyzed the imaging appearances of secondary intussusception in 16 children who have been proved by surgery and pathologic find-ings .Results The types of intussusceptions were as follows ：ileum-ileum type in 6 cases ,ileum-ileum-colon type in 1 case ,ileum-colon type in 9 cases .On the axial images with MPR ,the following signs were seen ：target sign or concentric circles sign （16 cases） ,comet tail sign with kidney-like mass （12 cases） ,blood vessel curling （8 cases） .Of these 16 pa-tients ,the primary lesions of secondary intussusceptions were confirmed by MSCT in 12 patients .Pathologic findings showed that the primary lesions included the enlargement of lymph node of intestinal wall （6 cases） ,intestinal malforma-tion （2 cases） ,lymphoma （1 case） ,polypus （3 cases） ,stenosis of distal ileum （2 cases） ,Crohn’s disease （1 case） ,and irritable intussusception after abdominal surgery （1 case） .Conclusion MSCT has a high value in the diagnosis of showing the secondary intussusception and its original lesions ,especially with the help of the MPR .