小儿梅克尔憩室CT表现特征分析

To Analyzed the CT Features of Children’s Meckel’s Diverticulitis

目的探讨小儿梅克尔憩室(MD)的CT表现,以提高对该病的诊断水平。方法回顾性分析11例(12人次)MD(8例经手术病理证实、3例未经手术病理证实但临床资料及CT表现典型)的临床资料及CT表现,与病理结果进行对照。所有患者客观数据采用SPSS 13.0软件进行统计学分析,计量资料采用平均数±标准差(x珋±s)表示,两两间比较采用t检验;计数资料间比较采用χ^2检验,P<0.05为差异有统计学意义。结果CT检查阳性11例,阳性率91.6%,术前CT诊断与手术结果相符6例,诊断符合率75%。病变位于右下腹9例,呈类肠管结构7例,与回肠相通9例,肠壁厚度大于3 mm 10例,肠壁明显强化7例,发现来自肠系膜动脉异常供血血管10例,MD肠管断面直径大于相邻回肠,但无统计学差异(P=0.126)。其管壁厚度及强化程度均高于相邻回肠,统计学分析具有显著性差异(P<0.05)。本组患者同时行超声检查,CT所发现征象和诊断符合率均高于超声,具有统计学差异(P<0.05)。结论小儿MD CT特征表现为病变段肠管管壁增厚,强化明显,肠管直接由增粗的肠系膜上动脉终末支供血,大部分可见与回肠相通。因此CT检查对该病术前诊断及鉴别诊断具有重要价值。

Objective To explore the CT features of Children's Meckel’s Diverticulitis so as to improve the diagnostic level of the disease.Methods We retrospectively analyzed the clinical data and CT features of subjects of which 8 cases of Children's Meckel’s Diverticulitis were confirmed by surgical pathology,3 cases with typical clinical data and CT features were not confirmed by surgical pathology.The CT image features were compared with surgical pathology.The objective data of the observed subjects were statistically analyzed using the statistical software SPSS13.0.The mean and standard devia-tion of the measurement data were calculated.χ2 test was used to compare counting data,and P<0.05 was considered sta-tistically significant.Results Preoperative CT examination was performed in 12 cases,CT positive findings were detected in 11 cases and the positive rate was 91.6%.The preoperative CT diagnosis was consistent with the result of operation in 6 cases and the diagnostic coincidence rate is 75%.It was found that the lesions were located in the right lower abdomen in 9 cases,showing intestinal-like structure in 7 cases,communicating with the ileum in 9 cases,the wall thickness was above 3mm in10 cases,the wall was significantly strengthened in 7 cases,and abnormal blood vessels were found in 10 cases.The diameters of the bowel section of Meckel’s Diverticulitis were greater than normal ileum section,but there was statisti-cal difference(P=0.126).The wall thickness and degree of enhancing were greater than normalileum and there was sta-tistical significance(P<0.05).All patients also underwent ultrasound examination and the findings detected by CT and di-agnostic coincidence rate of CT markedly exceeded ultrasound examination(P<0.05).Conclusion The characteristic features of pediatric Meckel's diverticulum are that the wall of the diseased section of bowel is thickened and has obvious en-hancement.The bowel section is directly supplied by a thickened superior mesenteric artery terminal branch,and in most cases communicates with the ileum.Therefore,CT examination has important value for preoperative diagnosis and differen-tial diagnosis of the disease.