化疗相关型肠壁积气的CT表现

CT Findings and Literature Review of Chemotherapy-associated Pneumatosis Intestinalis

目的探讨因化疗引起的肠壁积气的CT影像特点。方法回顾性分析4例因化疗引起的肠壁积气及14例非化疗原因引起的肠壁积气患者的CT特征,观察化疗型与非化疗型肠壁积气在积气类型、受累肠段、累及长度、门脉系统积气、肠壁增厚、腹腔游离气体、腹腔积液及渗出等情况。结果化疗相关型肠壁积气患者可无腹痛症状,CT显示肠壁积气多为蜂窝海绵状积气、累及结肠范围弥散、可伴有腹腔游离积气、无腹腔刺激症状,与其他可引起腹痛的非化疗型肠壁积气CT表现明显不同。结论化疗相关型肠壁积气CT表现较有特征性,有助于临床正确评估病情,减少手术及不良预后发生。

Objective To investigate imaging features on computed tomography(CT)in the diagnosis of pneumatosis intestinalis in patients with chemotherapy.Methods 4 cases with chemotherapy-associated and 14 cases with other reasons pneumatosis intestinalis were analyzed,retrospectively.Intestinal wall gas,affecting intestinal segment and involving length,portal vein gas,intestinal thickening,free gas in abdominal cavity,celiac effusion,and mesenteric exudation were recorded in pneumatosis intestinalis patients with chemotherapy or non-chemotherapy.Results Chemotherapy associated pneumatosis patients may show no abdominal pain symptoms,CT features include honeycomb spongiform pneumatosis,often involving colon and dispersion distribution,may accompany by free air in abdominal cavity,no celiac effusion and mesenteric exudation.These CT findings are significantly different from those of nonchemotherapy induced pneumatosis.Conclusion CT findings of chemotherapy-related pneumatosis intestinalis are unique,which could be helpful for clinician to correctly assess patient’s condition and reduce the incidence of surgery and poor prognosis.