缺血性结肠炎的CT表现

Multislice spiral CT features of ischemic colitis

目的探讨并总结缺血性结肠炎的CT表现特点,提高对该病的诊断准确性。方法回顾性分析空军军医大学西京医院2012年5月至2017年3月经CT、肠镜、病理、临床综合诊断等确诊的21例缺血性结肠炎的患者,按照发病至CT检查的时间分为急性期、非急性期。回顾性分析、总结其CT表现特点。结果缺血性结肠炎最常累及左半结肠,急性期对比非急性期特征性的CT征象是:肠壁弥漫性水肿增厚[(16.4±5.5)mm vs.(7.6±3.9)mm,P=0.000],肠壁分层(100%vs.36%,P=0.007)和病变肠管周围渗出(100%vs.14%,P=0.001)。所有患者未见肠系膜上、下动脉血栓,但约33%的患者可见分支狭窄或截断闭塞。结论缺血性结肠炎的CT表现具有一定的特征性,尤其是急性期病变,总结并掌握这些特点可以提高诊断的准确性。

Objective To explore the CT features of ischemic colitis and improve the diagnostic accuracy of the disease. Methods A total of 21 p Patients with 21 cases of ischemic colitis confirmed by CT,enteroscope,pathology and clinical comprehensive diagnosis were analyzed retrospectively from May 2012 to March 2017 in Xijing Hospital of Fourth Military Medical University. The patients were divided into collected by colonoscopy,pathology and clinical comprehensive diagnosis,and there were 7 cases of acute group and 14 cases of non-acute group according to the time from onset to CT examination. The CT features of CT were analyzed retrospectively. Results Ischemic colitis is was most frequently involved in the left colon. The CT features During of the acute phase were as follows compared with,the CT features of the non-acute phase characteristic were： diffuse swelling of the intestinal wall（ 16. 4 ± 5. 5 vs. 7. 6 ± 3. 9,P = 0. 000）,the stratification of the intestinal wall（ 100% vs. 36%,P = 0. 007） and the intestinal canal exudes（ 100% vs.14%,P = 0. 001）. There were no All patients did not see the superior mesenteric artery and the submesenteric artery thrombosis. But about 33% of the patients had narrow or truncated branchs. Conclusion The CT manifestations of ischemic colitis have certain characteristics,especially acute phase lesions. The summary and mastery of these features can improve the accuracy of diagnosis.