急性肠缺血的多层CT诊断

Multi-slice CT for diagnosis of acute mesenteric ischemia

急性肠缺血发病急,病死率高,临床表现无特异性,诊断困难.64层以上多层CT由于快速、亚毫米薄层扫描和精细的三维重建,可清楚显示肠系膜血管有无狭窄和闭塞,评估肠壁及肠系膜形态和血流灌注异常,快速准确诊断急性肠缺血、肠梗死及其病因,而成为临床怀疑肠缺血最有价值的一线检查方法.急性肠缺血病因病理、缺血程度和发病部位不同,以及有无肠壁出血或感染,其CT表现复杂多样.本文就各种原因的急性肠缺血不同阶段的多层CT表现和诊断价值进行系统阐述.

Acute mesenteric ischemia（AMI） has an acute onset and a high mortality rate with nonspecific clinical presentation and is difficult to diagnose.In recent years,due to fast submillimeter scanning and subtle threedimensional reconstruction,64-row multislice CT can distinctly demonstrate the stenosis and occlusion of the mesenteric vessels,assess the alteration of morphology and blood perfusion of the intestinal wall and mesentery,and promptly and accurately diagnose AMI,intestinal infarction and its etiology.Therefore,CT has become the most valuable and firstline diagnostic modality for evaluating patients with suspected AMI.AMI has different and complicated CT findings due to different etiology,pathology,extent,position,as well as with or without mural hemorrhage or infection.In this article,the multi-slice CT manifestations of AMI and its diagnostic value in various causes and different stages were systematically reviewed.