小肠出血的影像学检查

Imaging Examination of Small Intestinal Bleeding

目的 :分析小肠出血性病变的X线、DSA、核素扫描和CT表现 ,探讨小肠出血的影像学检查方法。材料和方法 :回顾分析45例经临床病理证实的小肠出血性病变的X线、DSA、核素扫描和CT表现。包括小肠平滑肌瘤10例、平滑肌肉瘤8例、小肠憩室5例、小肠血管畸形22例。结果 :小肠平滑肌瘤(肉瘤) ,小肠钡剂造影检出率为86 %(12/14) ,DSA为92 %(11/12) ,核素扫描为50 %(5/10) ,CT检查为100 %(8/8)。小肠憩室 ,小肠钡剂造影检出率为80 %(4/5) ,DSA为75 %(3/4) ,核素扫描为60 %(3/5) ,CT检查为67 %(2/3)。小肠血管畸形 ,小肠钡剂造影检出率0 %(0/20) ,DSA为73 %(16/22) ,核素扫描为44 %(7/16) ,CT检查为0 %(0/4)。结论 :小肠出血病人的检查应该以小肠钡剂造影和DSA作为常规 ,核素扫描是一种补充手段 。

To study the imaging findings and evaluate the imaging modalities in small intestinal bleeding.Materials and Method:The imaging appearances of small bowel enema(SBE),DSA,scintigraphy and CT findings of 45 cases with small intestinal bleeding proved by surgery and pathology were analyzed.The primary morbidities were 10 leiomyomas,8 leiomyosarcomas,5 diverticula and 22 vascular malformations of small intestine.Results:The positive rate for leiomyoma and leiomyosarcoma were 86% by SBE,92% by DSA,50% by scintigraphy and 100% by CT scan respectively;for diverticula,the rates were 80% by SBE,75% by DSA,60% by scintigraphy,67% by CT scan,and for vascular malformation,0% by SBE,73% by DSA,44% by scintigraphy and 0% by CT.Conclusion:Small intestinal enema and DSA are routine modalities for diagnosis of small intestinal hemorrhage.Scintigraphy can be regarded as an expletory method whereas CT scan will be taken when tumor lesion is suspected.