动脉粥样硬化性肠系膜缺血的多层CT诊断进展

Progress in multi-slice CT diagnosis of atherosclerotic mesenteric ischemia

随着人口老龄化、动脉粥样硬化发病率的增高,动脉粥样硬化性肠系膜缺血的发病率也逐渐增加,近十年来,肠系膜动脉粥样硬化已成为急性和慢性肠系膜缺血最常见的原因.动脉粥样硬化性肠系膜缺血发病隐匿,进展缓慢,易被忽视,其晚期CT表现典型,诊断准确性高,CT血管造影可见特异性表现:急性期的肠系膜动脉内血栓栓子,管腔狭窄、闭塞,慢性期的肠系膜动脉单发或多发钙化或非钙化斑块,多发狭窄、僵硬,分支血管减少.其早期无表现或表现无特异性,CT诊断困难.本文就动脉粥样硬化性肠系膜缺血的多层CT诊断价值和限度,以及影像诊断新技术进行系统阐述.

The incidence of atherosclerotic mesenteric ischemia increases gradually with the aging of the population and rising of the incidence of atherosclerosis. In the last decade, mesentericatherosclerosis has become the most common cause of acute and chronic mesenter ic ischemia. Atherosclerotic mesenteric ischemia often presents with an insidious onset and slow evolvement, and is easily overlooked.The CT manifestations of advanced mesenteric ischemia are classic with high diagnostic accuracy, and the specific findings of CT angiography include： thromboembolus and stenotic or occlusive mesenteric artery in acute stage, single or multiple calcified or non-calcified plaques, and multiple stenotic and stiff mesenteric arteries with reduced branching vessels in chronic stage. Early mesenteric ischemia, however, has no or nonspecific CT sign and is difficult to detect.This article discusses the diagnostic value and limitations of multi-slice CT in atherosclerotic mesenteric ischemia as well as some new imaging techniques for diagnosis of this condition.