慢性缺血性肠病MSCT表现:与非缺血性肠病对照

The MSCT Features in Chronic Ischemic Bowel Disease:Comparison with Non-ischemic Bowel Disease

目的:探讨慢性缺血性肠病的CT特征,以提高诊断正确率。方法:回顾性收集经内镜及临床证实的慢性缺血性肠病27例与35例非缺血性肠病患者资料,所有病例均行全腹部CT平扫+增强检查,对比分析两组病例影像学特点。结果:慢性缺血性肠病患者年龄偏大,合并基础病更为常见(P<0.05);两组病例均有病变肠管不同程度肠壁水肿及增厚、肠系膜渗出、靶征及轨道征,差异无统计学意义(P>0.05);慢性缺血性肠病组肠管强化降低(19/27,70.4%)、肠壁或肠壁下积气(8/27,29.6%)、肠系膜上动脉形态异常(27/27,100%),与非缺血性肠病对比,差异具有统计学意义(P<0.05);慢性缺血性肠病肠系膜上动脉直径为3.1±1.1mm,明显小于非缺血性肠病肠系膜上动脉直径5.7±1.4mm(P<0.05)。结论:慢性缺血性肠病常伴有肠系膜上动脉形态及直径异常,随病程进展MSCT特征性表现为病变肠管强化降低、肠壁或肠壁下积气。

Objective:To explore the CT features differences in chronic ischemic bowel diseases and improve diagnostic accuracy.Methods:27 cases chronic ischemic bowel disease and 35 cases nonischemic bowel diseases confirmed by endoscopy and clinic were analyzed retrospectively.All cases were performed abdomen Routine and enhanced Scan.The CT features were compared.Results:Patients with increased Chronic ischemic bowel disease were older,with more chronic disease(P<0.05);There were not significant differences in intramural edema,mesenteric exudation,target or orbit sign(P>0.05);comparison with non-ischemic bowel disease.Significant enhancement decline in chronic ischemic bowel disease were observed in 19 cases(19/27,70.4%);Segmental intestinal pneumatosis cystoides intestinalis or mural gas collection were observed in 8 cases chronic ischemic bowel disease(8/27,29.6%);Superior mesenteric artery paramorphia were observed in 27 cases chronic ischemic bowel disease(27/27,100%);these differences between two groups showed statistical significance(P<0.05).The mean diameter of the superior mesenteric artery in chronic ischemic bowel disease was 3.1±1.1mm,compared to 5.7±1.4mm in non-ischemic bowel disease(P<0.05).Conclusion:Chronic ischemic bowel diseases often accompany by abnormal shape and size in superior mesenteric artery.As the disease progresses,segmental intestinal poor enhancement,pneumatosis cystoides intestinalis or mural gas collection will be observed.