成人中肠未旋转的MSCT诊断价值

Diagnosis of midgut malrotation using MSCT in adults

目的探讨MSCT对成人中肠未旋转的诊断价值。方法选取并分析明确诊断的16例成人中肠未旋转(其中3例合并中肠扭转)患者的CT图像及临床资料。结果16例患者CT扫描均显示小肠(十二指肠水平段、空肠、回肠)聚集于右侧腹腔,盲肠及回盲部位于左侧腹腔,肠系膜血管“换位征”阳性,肠系膜血管“旋涡征”5例,其中3例合并中肠扭转经手术治疗。结论肠袢位置异常(十二指肠水平段、空肠、回肠位于右侧腹腔,盲肠及回盲部位于左侧腹腔)及肠系膜血管“换位征”是CT诊断成人中肠未旋转的特异性征象,合并肠系膜血管“旋涡征”则提示中肠扭转。

Objective To explore the diagnostic value of midgut malrotationin adults with multi-slice spiral CT(MSCT).Methods CT images and clinical data of 16 patients with midgut malrotation(including 3 patients with volvulus)were retrospectively analyzed.Results Among the 16 cases,small intestine(horizontal segment of duodenum,jejunum and ileum)clustered in the right abdominal cavity and ileocecum were on the left.Mesenteric blood vessel"translocation sign"was positive in 16 cases,and mesenteric blood vessel"vortex sign"was positive in 5 cases,including middle bowel volvulus treated by surgery in 3 cases.Conclusion Abnormal position of intestinal loop and mesenteric vascular"transposition sign"are the specific signs of CT diagnosis of midgut malrotationin in adults,and the combination of mesenteric vascular"vortex sign"suggests midgut volvulus.