成年人肠套叠49例CT分析

目的探讨成年人肠套叠CT表现及CT检查的意义。方法回顾性分析经CT检查并手术病理证实的成年人肠套叠49例的CT表现,并分析CT检查的意义。结果小肠套叠型12例,回-回-结肠型13例,回-结肠型9例,回-结-结肠型9例,结-结肠型6例。CT判断肠套叠正确45例,提示性诊断4例,套叠部位判断正确39例(79.6%);特发性肠套叠9例,继发性肠套叠40例,对原发病变判断正确14例;47例套叠头体部发现肿块状改变,分别呈“靶征“37例,“肾征“38例,不规则肿块改变9例,同时可见“靶征“及“肾征“29例,套叠体尾部双肠管征39例;套叠部远端肠腔内见造影剂30例;增强扫描41例,肿块状影与正常肠壁同步强化35例,肿块状影无强化或轻微强化6例,胃次全手术史8例。结论CT对成人肠套叠诊断准确,套叠部位判断有一定价值,但对病因判断意义不大,同时可提示套叠肠管坏死的可能性以及估计是否为完全性肠梗阻。

Evaluation the value of CT scanning in diagnosing adult intussusception (report of 49 cases)

Objective To study the CT features and evaluate the clinical significance of spiral CT in adult intussusception. Methods The CT findings of 49 adult intussusceptions proved by operation and pathology were retrospectively analyzed. Results The type of intussusception: small intestine-small intestine 12 cases, ileum-ileum-colon ascendens 13 cases, ileum-colon ascendens 9 cases, ileum-colon-colon ascendens 9 cases, colon-colon ascendens 6 cases. The accuracy of CT diagnostic in adult intussusception was 91.8% (45/49), 4 cases were suggestive diagnosis. The accuracy of CT diagnostic type of adult intussusception was 79.6% (39/49), 9 cases intussusception was idiopathic and the secondary intussusception was more commonly (n=40). The accuracy of CT diagnostic in primary pathology was 28.6% (14/49). Masses were found in 47 cases, including target masses (n=37), kidney shape masses (n=38), anomaly masses (n=9), target masses and kidney masses was found simultaneity in 29 cases. Double intestines signs was found from the body in 39 cases. Contrast media appeared in the intestines wall distal the intussusception in 30 cases. Contrast-enhancement was perform in 41 cases. The masses showed synchronous enhancement with the normal intestines wall in 35 cases compared with not being synchronous enhancement in 6 cases, 8 cases had history of stomach operation. Conclusion There was a high sensitivity of CT to detect intussusception and useful to diagnostic the type, but no remarkable significance to diagnostic the primary pathology. CT was useful to suggest necrosis of intestines wall and complete intestinal obstruction.