机械性肠梗阻CT诊断

CT diagnosis of intestinal obstruction

目的 :总结机械性肠梗阻CT表现及诊断价值。方法 :分析 30例经手术 ( 16例 )及临床 ( 14例 )证实的肠梗阻CT及临床资料 ,比较腹部平片与CT对肠梗阻存在、定位、病因、有否绞窄以及治疗方法选择的价值。结果 :CT证实肠梗阻存在 10 0 % ,平片约 70 % ;病因诊断准确性CT为 96 % ,平片 13 % ;CT能对肠肿瘤及时发现并分期 ( 9例 ) ,及早诊断肠绞窄( 2例 )及发现肠外肿块 ( 4例 ) ,有助于及早选择外科治疗。结核、局限炎症、肠套叠等首选保守治疗。常规CT检查发现肠管异常扩张应扩大扫描范围 ,往往能发现引起肠梗阻的病因 (本组因此偶然发现肠肿瘤 3例 )。结论 :肠梗阻或疑有肠梗阻的病人在平片、B超诊断信息不足时尽早CT检查对于明确病因。

Objective:To analyze the CT features of intestinal obstruction and its diagnostic value.Methods: CT features and clinical data of 30 cases of intestinal obstruction confirmed by surgical findings (16 cases) and clinical followup(14 cases) were analyzed.The diagnostic value was compared between CT and plain film on the existence,location,cause,strangulation of intestinal obstruction and the value on choice of appropriate treatment.Results:The existence of intestinal obstruction was diagnosed in 100% on CT scans,and 70% on plain film.The diagnostic accuracy of the cause of intestinal obstruction was 96% on CT and 13% on plain film.Intestinal carcinoma was diagnosed and staged by CT in 9 cases, and CT also showed strangulation (n=2),extraluminal masses (n=4) and herniation (n=2).These were helpful for deciding earlier operation.Tuberculosis (n=3),local inflammation (n=2) and intussusception(n=1) were recommended to take nonoperative treatment.3 cases of intestinal carcinoma were detected by extending scanning areas,when abnormal dilatation of intestine found on routine CT scan.Conclusion:Patients with intestinal obstruction or suspected of intestinal obstruction should take CT scan as soon as possible when plain film or ultrasound is not so informative.It is valuable for earlier diagnosis of causes,choice of appropriate treatment and favourable prognosis.