MSCTA对肠系膜上动脉压迫性疾病的诊断价值

The value of MSCTA in diagnosis of superior mesenteric artery oppressive disease

目的 :探讨MSCTA对肠系膜上动脉压迫性疾病的诊断价值。方法 :选择63例检查正常者、16例十二指肠淤积症患者及9例胡桃夹综合征患者,行MPR后测量肠系膜上动脉与腹主动脉的夹角(α)、左肾静脉层面及十二指肠水平部中心水平层面肠系膜上动脉与腹主动脉之间的距离(d1、d2)。结果 :检查正常者及胡桃夹综合征患者α分别为58.53°±23.55°和12.23°±5.82°,d1分别是(12.23±5.82)mm和(2.88±0.93)mm,差异均有统计学意义(t=10.62,t=11.73,均P<0.05)。检查正常者及十二指肠淤积症患者α分别为58.53°±23.55°和19.00°±5.42°,d2分别为(12.68±6.03)mm和(5.06±2.69)mm,差异均有统计学意义(t=12.11,t=7.50,均P<0.05)。结论:MSCTA能够很好地显示肠系膜上动脉与周围组织的关系,准确测量a、d1、d2,为诊断胡桃夹综合征、十二指肠淤积症提供客观依据。

Objective：To investigate the value of MSCTA in diagnosis of superior mesenteric artery oppressive disease. Methods：A total of 63 cases with normal inspectors and 16 cases patients with duodenum filled syndrome,9 cases patients with nutcracker syndrome,that were analyzed retrospectively,the angle （α） of SMA and AA,the distance （d1,d2） between SMA and AA at the level of the left renal vein and the central level of the horizontal part of the duodenum,that were measured by multi-planar reformation（MRP）. Results：The angle（α） of SMA and AA was 58.53°±23.55° and 12.23°± 5.82° in normal inspectors and the patients with nutcracker syndrome,respectively. The distance（all） between SMA and AA was （12.23± 5.82）mm and （2.88±0.93）mm,there were positive correlation （t=10.62,t=11.73,P〈0.05）. The angle（α） of SMA and AA was 58.53°±23.55° and 19.00° ±5.42° in normal inspectors and the patients with duodenum filled syndrome. The distance （d2） between SMA and AA was （ 12.68 ± 6.03） mm and （5.06 ± 2.69）mm. There were positive correlation （t=12.11, t=7.5,P〈0.05）. There were 2 patients that also suffered from duodenum filled syndrome and nutcracker syndrome. Conclusion：Muhi-slice spiral CT angiography can well display relationship between SMA and the surrounding tissue;There is accurate measurement of the angle between SMA and AA ;There is accurate measurement of the distance between SMA and AA in the maximum level of the left renal vein and the central level of the horizontal part of the duodenum. The results could provide objective basis for the diagnosis of nutcracker syndrome and duodenum filled syndrome.