乙状结肠扭转的多排螺旋CT特征

MSCT Features of Sigmoid Volvulus

目的:总结乙状结肠扭转的多排螺旋CT的影像学表现,以提高急诊乙状结肠扭转诊断的准确率。方法:回顾性分析21例经手术证实或临床反复发作乙状结肠梗阻病例的CT定位相、横断面及重建图像的特点。结果:定位相中倒U形扩张肠腔的表现最多见(52.4%),其次是直肠内未见气体(38.1%)及咖啡豆样表现(28.5%)。横断面图像中漩涡征的表现最多(62.0%),其次是交叉样改变(47.6%)和鸟嘴样改变(38.0%)。多平面重建可以较横断面图像多发现2例患者的漩涡征。结论:乙状结肠扭转有一系列的CT影像学表现,需要结合定位相、横断面及多平面重建的综合表现,才能提高准确率。

Purpose： To evaluate the CT features of sigmoid volv-ulus and to improve the accuracy of preoperative diagnosis. Methods： We retrospectively reviewed the CT features of 21 cases of sigmoid volvulus. The CT features on scout imaging, cross-sectional imaging and multi-planar reconstructive imaging were analyzed. Results： The most sensitive findings on scout imaging were an inverted-U-shaped disproportionate sigmoid enlargement （52.4%）, absence of rectal gas （38.1%）, and coffee bean sign （28.5%）. The mainly specific cross-sectional imaging features were whirlpool sign （62.0%）, X-mark-the-spot sign （47.6%）, and beak sign （38.0%）. More whirlpool sign could be shown on the multi-planar reconstructive images in 2 patients. Conclusion： Sigmoid volvulus has a spectrum of CT findings. The combination of the features of scout imaging, cross-sectional imaging and multi-planar reconstructive imaging may improve the diagnostic confidence.