超声诊断肠系膜血管闭塞25例

Ultrasonographic Diagnosis of Mesenteric Vascular Occlusion: A Report of 25 Cases

目的:探讨肠系膜血管闭塞(MVO)的超声表现及肠系膜动、静脉性血管闭塞超声征象的差异。方法:回顾性分析25例MVO患者的临床特点及超声声像图特征,对比动脉性及静脉性肠系膜血管闭塞的超声声像图表现。结果:25例MVO患者中包括肠系膜动脉闭塞13例,肠系膜静脉血栓形成12例。静脉性血管闭塞出现增厚肠壁间"串珠样"低回声的频率更高(75%vs 0,P<0.001);动脉性血管闭塞出现壁层结构不清晰(92%vs 33%,P=0.004);肠管张力消失、塌陷(69%vs 8%,P=0.004);肠壁间血流信号消失(92%vs 25%,P=0.001)的频率更高。结论:超声检查不仅可以提示MVO的发生,而且有助于肠系膜动脉与静脉闭塞之间的鉴别。

Objective（MVO） and different ultrasonography features between mesenteric artery occlusion and mesenteric venous thrombosis.Methods Total 25 patients with MVO were retrospectively analyzed for clinical manifestations and ultrasonography findings. The ultrasonography features between mesenteric artery occlusion and mesenteric venous thrombosis were compared.Results Of 25 patients, 13 cases were those with mesenteric artery occlusion and 12 cases with mesenteric venous thrombosis. A thick bowel wall with ＂beaded＂ low echo was more frequently associated with mesenteric venous thrombosis（75% vs 0, P〈0.001）, whereas bowel wall structure fuzziness（92% vs 33%, P=0.004）, bowel wall lacked expansibility（69% vs 8%, P=0.004）,and diminished bowel Doppler blood flow signal（92% vs 25%,P=0.001）were more frequent in mesenteric artery occlusion.Conclusion Ultrasonography can not only detect MVO, but also contribute to the identification of mesenteric artery occlusion and mesenteric vein thrombosis.