MSCT在自发性孤立性肠系膜上动脉夹层诊断中的特点

Diagnosis of spontaneous isolated superior mesenteric artery dissection using multislice computed tomography

目的:探讨MSCT在自发性孤立性肠系膜上动脉夹层(SISMAD)诊断中的特点。方法:回顾分析2018年6月-2021年12月间苏州市相城人民医院与苏州大学附属第二医院收治的86例SISMAD患者(苏州大学附属第二医院77例,苏州市相城人民医院9例)的CT影像及临床资料。分析SISMAD发生部位、管径大小、管腔密度、管周脂肪浸润及CT增强特点,提炼SISMAD CT平扫及增强特征。结果:86例SISMAD发生在肠系膜上动脉垂直部上端68例、管周晕征:45例(约52.3%)、管腔密度增高:44例(约51.2%);86例SISMAD患者,Ⅰ型31例,Ⅱ型17例,Ⅲ型12例,Ⅳ型26例。结论:CT平扫肠系膜上动脉管径增粗、管周晕征提示SISMAD的可能性,进一步增强CT可明确诊断。

Objective To investigate the characteristics of MSCT in the diagnosis of spontaneous isolated superior mesenteric artery dissection(SISMAD)and improve its detection rate.Methods The imaging and clinical data of 86 patients with SISMAD were retrospectively analyzed.The location,diameter,lumen density,peritubular fat infiltration and CT enhancement characteristics of SISMAD were analyzed,and the plain and enhanced CT features of SISMAD were extracted.Results The diameter of superior mesenteric artery in SISMAD patients were 68 cases,peritubular halo sign was 45 cases(about 52.3%),lumen density was increased in 44 cases(about 51.2%);There were 86 patients with SISMAD,including 31 cases of type I,17 cases of type II,12 cases of type III and 26 cases of type IV.Conclusion The thickening of superior mesenteric artery diameter,peritubular halo sign on plain CT suggest the possibility of SISMAD.Enhancement of CT can make a definite diagnosis.