CT定量测量鉴别粘连性小肠梗阻所致肠梗死和缺血的价值

Using CT quantitative measurement to differentiate small bowel infarction from ischemia in patients with adhesive small bowel obstruction

目的探讨CT定量测量鉴别粘连性小肠梗阻所致肠梗死和缺血的价值。方法测量经手术证实的14例小肠梗死和16例缺血者病变肠壁的最大CT值,比较两组间病变肠壁CT值和增强净增CT值有无差别,分析有意义指标鉴别梗死和缺血的价值。结果门静脉期病变肠壁净增CT值、病变与正常肠壁净增CT值之比在梗死组显著低于缺血组(P值分别为0.034、0.004)。门静脉期病变肠壁净增CT值≤11.5HU、门静脉期病变与正常肠壁净增CT值之比≤0.27预测小肠梗死的敏感度和特异度分别为81.3%、64.3%,81.3%、78.6%。结论测量门静脉期病变肠壁净增CT值有助于鉴别粘连性小肠梗阻所致的肠梗死和缺血。

Objective To investigate the value of quantitative measurement on CT in differentiating small bowel ischemia from infarction in patients with adhesive small bowel obstruction(ASBO).Methods Maximal CT attenuation of abnormal bowel wall was measured in 14 patients with surgically proven small bowel infarction and 16 with bowel ischemia.CT attenuation and net increase of CT attenuation of abnormal bowel wall were compared between the two groups,and differential value of useful CT findings was analyzed.Results Net increase of CT attenuation of abnormal bowel wall and the ratio of net increase of abnormal to normal bowel wall on portal venous phase in infarction group were statistically lower than that in ischemia group.The sensitivity and specificity in predicting bowel wall infarction of a net increase lower than 11.5 HU of CT attenuation of abnormal bowel wall and 0.27 of net increase were 81.3%,64.3%;81.3%,78.6%,respectively.Conclusion Measurement of net increase of CT attenuation of abnormal bowel on portal venous phase CT is useful in differentiating small bowel infarction from ischemia in patients with ASBO.