【摘要】 目的:探讨多层螺旋CT(MSCT)对肠系膜缺血的诊断价值和临床意义。方法:对43例怀疑肠系膜缺血患者行MSCT检查,包括平扫、动脉期和门静脉期扫描,采用容积成像(VR)、多平面重组(MPR)和最大密度投影(MIP)进行动脉和门脉成像,评价并分析异常的MSCT征象。结果:肠系膜上动脉栓塞7例,管腔内血栓影,肠管扩张积气、积液;肠壁无强化,5例肠壁变薄,2例肠壁水肿增厚。肠系膜上静脉血栓形成36例,肠管扩张积气、积液33例;肠壁水肿增厚伴密度改变(面包圈征)25例;肠系膜血管增粗,脂肪渗出(缆绳征)17例;肠系膜血管走行异常(漩涡征)9例;肠系膜静脉管腔内充盈缺损36例,管壁强化(靶征)27例。结论:MSCT扫描与三维重组技术相结合能准确诊断肠系膜缺血并明确其缺血程度、范围,是一种有效的、无创的影像学检查手段。更多还原

【Abstract】 Objective:To explore the value and clinical significance of multi-slice spiral(MS) CT in diagnosis of mesenteric ischemia.Methods:MSCT,including plain scan,the arterial phase scan and the portal vein phase scan,was performed in 43 patients who were suspected of mesenteric ischemia.The mesenteric arteries and portal veins were imaged with techniques including volume-rendered,multi-planar reconstruction,and maximum intensity projection.The abnormal MSCT findings were analyzed.Results:The lumen thrombosis shadow,bowel dilatation and/or air-fluid levels were commonly seen in 7 cases of mesenteric artery embolization and bowel wall no strengthening,thinning in 5 cases,edema thickening in 2 cases.The thrombus of lower density in mesenteric vein in 36 cases,bowel dilatation and/or air-fluid levels in 33 cases;Thickened bowel wall in 25 cases(bread ring sign);The mesenteric vascular enlarged and effusion of mesenteric fat(strand sign) in 17 cases;The mesenteric vascular abnormal route(whirl sign) in 9 cases;Mesenteric vein lumen had filling defect in 36 cases,and venous wall strengthening(target sign) in 27 cases.Conclusion:The degrees and extension of mesenteric ischemia can be accurately diagnose by MSCT scan in combination with 3D reconstruction,it is a effective and non-invasive circulation imaging examination.更多还原