【摘要】 目的 评价多层螺旋CT在诊断急性肠缺血、判断缺血程度及缺血病因中的价值。方法 回顾性分析32例确诊为急性缺血性肠病患者的CT资料。采用多层螺旋CT扫描,32例均行平扫,22例行双期增强扫描,所得图像均进行三维重建。结果 26例肠壁增厚,其中可逆性缺血19例,不可逆缺血7例。4例肠壁变薄者全部见于不可逆缺血。17例肠壁密度减低,15例肠壁密度增高。增强后,可逆性缺血中有9例肠壁强化增加,不可逆性缺血中7例肠壁强化减弱或不强化,4例非阻塞性肠缺血表现为部分强化。11例肠壁积气和9例肠管扩张均见于不可逆性肠缺血。28例有缆绳征。29例患者找到肠缺血之病因。结论 CT能准确诊断急性肠缺血,特别是在判断缺血程度和缺血病因上具有重要价值。更多还原

【Abstract】 Objective To evaluate the capacity of multi-slice spiral computed tomography(MSCT) in diagnosing acute mesenteric ischemia(AMI) and determining its extent and etiology.Methods CT manifestations of 32 patients with clinically confirmed AMI were retrospectively analyzed.Plain CT scans were performed in all 32 patients and two-phase contrast-enhanced CT scans were performed in 21 patients.Three-dimensional(3D) reconstructions of the source images were followed.Results 26 cases were revealed having bowel wall thickening,of which 19 cases were reversible bowel ischemia and 7 cases were irreversible ones.4 cases with thin bowel wall were irreversible ischemia exclusively.17 and 15 cases were revealed with hypo-and hyper-attenuating bowel respectively.After injection of contrast medium,the bowel walls were enhanced in 9 cases in reversible ischemia,the bowel walls were no or decreased enhanced in 7 cases in irreversible ischemia,and partial enhancement was seen in 4 cases with non-occlusive ischemia.11 cases with pneumatosis and 9 cases with luminal dilation were irreversib le ones exclusively.28 cases were revealed with mesenteric stranding.Through MSCT and 3D reconstruction,the etiology of AMI was determined in 29 cases.Conclusion MSCT is quite helpful in accurately diagnosing AMI.Especially,it is of great value to determine the extent and etiology of AMI.更多还原