【摘要】 目的探讨肠及肠系膜损伤的CT表现特点。方法12例经手术证实的肠及肠系膜损伤病例,主要观察(1)肠管破裂,腹腔游离气体的分布特点。(2)腹膜腔内游离积液的密度、腹水聚集部位与肠及肠系膜损伤部位的关系。(3)肠及肠系膜改变的CT表现形式。结果(1)手术发现肠管不同程度穿孔、撕裂5例,4例腹腔内肠管外可见游离气体;1例空肠小穿孔,CT未发现腹腔游离气体;气体的多少与肠管破裂部位及裂口大小有关。(2)腹腔内游离积液12例,腹水密度较高(>35HU),损伤部位肠间积液9例。(3)肠管改变,肠壁增厚、肠管扩张、连续层面肠管的连续性中断。(4)肠系膜水肿,较广泛或局限性肠系膜脂肪密度增高,见条状影,系膜间见大小不等血肿影(>50HU)。结论腹腔肠管外游离气体、密度较高游离积液、肠间积液、肠系膜密度改变,常可做出肠及肠系膜损伤的可靠CT诊断。更多还原

【Abstract】 Objective To discuss the CT features of intestinal and mesenteric injury. Methods All CT data of 12 patients with intestinal and mesenteric injury proved by operation were reviewed retrospectively. What we observed fell into 3 aspects:(1)the distributive characteristic of intra-abdominal dissociated gas coming from the ruptured intestine; (2)the relationship of the ascites’density and sites to the sites of intestinal and mesenteric injury(;3)the CT features of intestinal and mesenteric injury. Results (1) Among 5 cases with intestinal rupture, CT showed intra-abdominal dissociated gas in 4 cases, while not in 1 case with small perforation of jejunum. It showed that the amount of dissociated gas was related to the site and size of intestinal rupture.(2)ALL 12 cases had the signs of ascites on CT images, and CT scanning found fluid-filled with higher density(>35HU) between the intestines in 9 cases. (3) CT showed the affected intestine dilated, its walls thickened and its continuity was interrupted. (4) CT found the signs of mesenteric edema(>35HU) with the shadow of haematoma varying in size between mesenteries. Conclusion According to the intra-abdominal dissociated gas, fluid-filled with higher density and alteration in density of mesentery on CT images, CT scanning is reliable in the diagnosis of intestinal and mesenteric injury.更多还原