55例肠系膜血管病变患者64排128层螺旋CT血管造影表现分析

Findings of 64-line 128-slice Spiral CT Angiography in 55 Patients with Mesenteric Vascular Lesions

目的分析55例肠系膜病变血管患者64排128层螺旋CT血管造影表现。方法选取2010—2017年河北工程大学附属医院收治的肠系膜血管病变患者55例,均行64排128层螺旋CT血管造影检查,回顾性分析其64排128层螺旋CT血管造影表现。结果 (1)肠系膜上动脉缺血患者30例,CT血管造影表现为肠系膜上动脉钙化、狭窄、血栓形成。(2)肠系膜上动脉缺血综合征患者2例,CT血管造影表现为十二指肠第一、二部扩张,肠系膜上动脉与腹主动脉的夹角变小;胡桃夹综合征患者6例,CT血管造影表现为左肾静脉受压及远端左肾静脉扩张。(3)5例患者CT血管造影清晰显示肠系膜上动脉结构异常。(4)肠系膜上静脉栓塞12例,CT血管造影表现为门静脉主干及肠系膜上静脉广泛性充盈缺损。结论 64排128层螺旋CT血管造影能清晰显示肠系膜血管病变,可作为诊断肠系膜血管病变的影像学检查手段。

Objective To analyze the findings of 64-line 128-slice spiral CT angiography in 55 patients with mesenteric vascular lesions. Methods A total of 55 patients with mesenteric vascular lesions were selected in the Affiliated Hospital of Hebei University of Engineering from 2010 to 2017,all of them received 64-line 128-slice spiral CT angiography,and the findings were retrospectively analyzed. Results（1）We found 30 cases with superior mesenteric artery ischemia,the CT angiography examination results showed calcification,stenosis and thrombosis of superior mesenteric artery.（2）We found 2 cases with superior mesenteric artery ischemic syndrome,the CT angiography examination results showed expansion of the first and second parts of duodenum,angle between superior mesenteric artery and abdominal aorta decreased;found 6 cases with nutcracker syndrome,the CT angiography examination results showed compressed left renal vein and expansion of distal left renal vein.（3）We found 5 cases with clear superior mesenteric artery structural abnormality under CT angiography.（4）We found 12 cases with superior mesenteric venous thrombosis,the CT angiography examination results showed extensive filling defect of main portal vein and superior mesenteric vein. Conclusion Mesenteric vascular lesions can be clearly observed by 64-line 128-slice spiral CT angiography,64-line 128-slice spiral CT angiography may served as one of imaging examination means for mesenteric vascular lesions.