绞窄性肠梗阻MDCT表现

MDCT Findings of Strangulated Intestinal Obstruction

目的:探讨急诊中绞窄性肠梗阻的多排螺旋CT(MDCT)的影像表现。方法:分析经手术证实的29例绞窄性肠梗阻(SIO)患者的临床资料及MDCT资料,经多方位重建和多窗位的技术处理,对绞窄性肠梗阻患者CT的肠管影像改变(肠腔的扩张、积液、肠壁厚度、密度的改变),肠系膜的CT影像改变(肠系膜的模糊积液、旋转、门静脉的变化),腹腔内的CT影像改变(腹水、气腹)及增强CT影像改变(肠壁的强化改变,肠系膜血管是否栓塞)深入研究。结果:29例患者中共检出肠腔扩张、积液26例,肠壁密度变化、增厚18例,肠壁、门静脉内积气2例,肠系膜的模糊、积液19例,缆绳征11例,漩涡征9例,鸟嘴征5例,腹腔积液12例,肠系膜血管栓塞3例及肠壁不强化5例。结论:多排螺旋CT识别绞窄性肠梗阻的MDCT征象细节对提高绞窄性肠梗阻的诊断及其鉴别诊断有较好的应用价值。

Objective: To evaluate multi-detector row spiral CT(MDCT) in imaging the emergency patients with strangulated intestinal obstruction(SIO). Methods: Twenty-nine patients with SIO confirmed by surgery were included in this study. All patients’ clinical data and MDCT data were analyzed. After multiplanar reconstruction and multi window position analysis, CT characteristics of bowel(intestinal cavity expansion, effusion, intestinal wall thickness and density change), CT characteristic changes of mesentery(fuzzy effusion, mesenteric rotation,portal vein changes), image changes within the abdominal cavity(ascites, pneumoperitoneum) and enhanced CT imaging changes(bowel wall enhancement, mesenteric vascular embolism) were analyzed. Results: Of all the 29 participants, 26 cases have luminal dilatation changes, density changes and wall thickening of bowel were found in 18 cases, abnormal air accumulation at intestinal wall and in the portal vein were found in 2 cases, omesentericeffusion were found in 19 cases, stranding sign were found in 11 cases, the whirlpool sign were found in 9 cases,beak sign were revealed in 5 cases, abdominal dropsy were found in 12 cases, 3 cases have mesenteric vascular embolization, intestinal wall enhancement in 5 cases were found after intravenous injection of contrast medium.Conclusion: Careful identification of imaging details of SIO patients using MDCT has a better application value to improve the diagnosis and differential diagnosis in SIO patients.