多层螺旋CT在肠系膜血管病变所致急腹症中的诊断价值

Multi-slice CT in diagnosis of acute abdomen caused by mesenteric vascular lesions

目的 评价多层螺旋CT在肠系膜血管病变所致急腹症患者中的诊断价值.方法 回顾性分析23例肠系膜血管病变所致急腹症患者的CT表现.结果 肠系膜扭转12例,其中肠系膜血管“漩涡征”11例,肠管漩涡征9例,“缆绳征”9例,“靶环征”8例,“鸟喙征”8例,CT均能正确判断扭转的位置及方向.肠系膜动脉栓塞4例,肠系膜上静脉内血栓形成7例,均见肠系膜动静脉增宽,增强扫描管腔内见充盈缺损,CT均能清楚显示肠系膜动静脉血管内充盈缺损.结论 CT能够对肠系膜血管病变所致急腹症患者做出准确的定位和定性诊断,有利于治疗方案的选择及预后.

Objective To assess the values of multi-slice CT angiography （MSCTA） for diagnosing acute abdomen caused by mesenteric vascular lesions.Methods The MSCTA findings of 23 patients with acute abdomen caused by mesenteric vascular lesions were retrospectively analyzed.Results Among the 23 patients,small bowel volvulus （SBV） were found in 12 cases.The main signs included ＂ whirlpool＂ of vessels in 11,＂ whirlpool＂ of intestine in 9,＂cable sign＂ in 9,＂ target sign＂ in 8,and ＂beak sign＂ in 8.The location and direction of SBV were correctly diagnosed in all 12 patients.Mesenteric arterial embolization were found in 4 patients and superior mesenteric venous thrombosis in 7 patients.Mesenteric vessels were enlarged in all cases.Filling defect of mesenteric vessels were detected in all cases on enhanced CT and CTA.Conclusions MSCTA can make a localization and qualitative diagnosis of patients with acute abdomen caused by mesenteric vascular lesions,and it is useful for surgery planning and prognosis.