Effects of prostaglandin E(1) injection through the superior mesenteric artery on the hemodynamics of hepatocellular carcinoma.

OBJECTIVE: The purpose of our study was to assess the effects of portal blood flow on contrast enhancement in hepatocellular carcinoma lesions on CT hepatic arteriography. SUBJECTS AND METHODS: We examined 43 tumors in 39 patients who simultaneously underwent CT during arterial portography and CT hepatic arteriography for examination of liver tumors and then CT hepatic arteriography with prostaglandin E(1) injection via the superior mesenteric artery. All lesions pathologically confirmed to be hepatocellular carcinomas exhibited portal perfusion defects on CT during arterial portography. Changes in CT attenuation, size, and shape of liver tumors visualized on CT hepatic arteriography after intraarterial injection of prostaglandin E(1) were studied. In addition, changes in CT attenuation of the liver parenchyma surrounding the tumor were measured. RESULTS: The CT attenuation increased significantly after injection of prostaglandin E(1) in 91% (39/43) of the lesions (mean increase from 176.4 to 206.6 H; p = 0.0006, paired t test). The size and shape of the enhanced area generally did not change. The CT attenuation of the liver parenchyma surrounding each liver tumor significantly decreased in 58% (25/43) of the hepatocellular carcinoma lesions (mean decrease from 94.8 to 92.0 H; p = 0.0166, paired t test) and lesion conspicuity increased in 91% (39/43) of the tumors. CONCLUSION: Lesion conspicuity on CT hepatic arteriography between hepatocellular carcinoma and the surrounding liver parenchyma increased because of greater portal perfusion after the prostaglandin E(1) injection.     

Preoperative evaluation of hepatocellular carcinoma: combined use of CT with arterial portography and hepatic arteriography

OBJECTIVE: This study was undertaken to determine the usefulness of combined CT during arterial portography and CT hepatic arteriography in the preoperative evaluation of patients with known or suspected hepatocellular carcinoma and to describe the findings on CT during arterial portography and CT hepatic arteriography by which hepatocellular carcinomas may be differentiated from pseudolesions. SUBJECTS AND METHODS: This study included 137 patients who underwent combined CT during arterial portography and CT hepatic arteriography for the preoperative evaluation of known or suspected hepatocellular carcinoma. The images were prospectively evaluated to identify focal hepatic lesions and their differential diagnoses (hepatocellular carcinoma versus pseudolesion). We assessed the diagnostic accuracy of our prospective interpretation by comparing the interpretations with the results of histopathology or follow-up imaging. We also retrospectively analyzed imaging features seen on CT during arterial portography and CT hepatic arteriography-the size, shape, and location of the lesion within the liver; attenuation of the lesion; and opacification of the peripheral portal vein branches on CT hepatic arteriography. RESULTS: One hundred and forty-nine hepatocellular carcinomas (75 lesions confirmed at histopathology and 74 lesions on follow-up imaging) were found in 120 patients, and 104 pseudolesions (15 lesions confirmed at histopathology and 89 lesions on follow-up imaging) were found in 91 patients. The sensitivity of our prospective interpretations was 98.7%, and the specificity of our prospective interpretations was 90.4%. Our positive and negative predictive values were 93.6% and 97.9%, respectively. We found that hepatocellular carcinomas were larger, more frequently nodular, and more likely to be located intraparenchymally than were the pseudolesions (p < 0.01). Opacification of the peripheral portal vein branches on CT hepatic arteriography was detected in 36 pseudolesions (34.6%) but in none of the hepatocellular carcinomas (p < 0.01). CONCLUSION: Combining CT during arterial portography and CT hepatic arteriography is useful for the preoperative evaluation of patients with known or suspected hepatocellular carcinoma. Familiarity with the imaging features of hepatocellular carcinomas and pseudolesions can help in the accurate differentiation of hepatocellular carcinomas from pseudolesions.     

Pseudolesion in segments II and III of the liver on CT during arterial portography caused by aberrant right gastric venous drainage

We report three cases of pseudolesions caused by aberrant right gastric venous drainage (AGVD) in segment II/III of the liver as demonstrated on CT during arterial portography (CTAP). On CTAP, the lesions were seen as wedge-shaped perfusion defects, and on hepatic arteriography, AGVD directed to the area with the perfusion defect was visible in all three cases. When a perfusion defect is detected at the edge of segments II/III at CTAP, a pseudolesion caused by AGVD should be suspected.     

Transcatheter CT Arterial Portography and CT Hepatic Arteriography for Liver Tumor Visualization during Percutaneous Ablation

PurposeTo evaluate the feasibility of combining transcatheter computed tomography (CT) arterial portography or transcatheter CT hepatic arteriography with percutaneous liver ablation for optimized and repeated tumor exposure.Materials and MethodsStudy participants were 20 patients (13 men and 7 women; mean age, 59.4 y; range, 40–76 y) with unresectable liver-only malignancies—14 with colorectal liver metastases (29 lesions), 5 with hepatocellular carcinoma (7 lesions), and 1 with intrahepatic cholangiocarcinoma (2 lesions)—that were obscure on nonenhanced CT. A catheter was placed within the superior mesenteric artery (CT arterial portography) or in the hepatic artery (CT hepatic arteriography). CT arterial portography or CT hepatic arteriography was repeatedly performed after injecting 30–60 mL 1:2 diluted contrast material to plan, guide, and evaluate ablation. The operator confidence levels and the liver-to-lesion attenuation differences were assessed as well as needle-to-target mismatch distance, technical success, and technique effectiveness after 3 months.ResultsTechnical success rate was 100%; there were no major complications. Compared with conventional unenhanced CT, operator confidence increased significantly for CT arterial portography or CT hepatic arteriography cases (P < .001). The liver-to-lesion attenuation differences between unenhanced CT, contrast-enhanced CT, and CT arterial portography or CT hepatic arteriography were statistically significant (mean attenuation difference, 5 HU vs 28 HU vs 70 HU; P < .001). Mean needle-to-target mismatch distance was 2.4 mm ± 1.2 (range, 0–12.0 mm). Primary technique effectiveness at 3 months was 87% (33 of 38 lesions).ConclusionsIn patients with technically unresectable liver-only malignancies, single-session CT arterial portography–guided or CT hepatic arteriography–guided percutaneous tumor ablation enables repeated contrast-enhanced imaging and real-time contrast-enhanced CT fluoroscopy and improves lesion conspicuity.     

Increased hepatic arterial blood flow after decreased portal supply to the liver parenchyma owing to intrahepatic portosystemic venous shunt: angiographic demonstration using helical CT

This study was conducted to investigate the haemodynamics of the liver parenchyma in the presence of intrahepatic portosystemic venous shunt. 3 patients with intrahepatic portosystemic venous shunts and 24 patients with normal intrahepatic haemodynamics underwent both CT arterial portography and CT during hepatic arteriography. Angiographic findings with helical CT were compared, and CT attenuated values were measured in both groups. The liver parenchyma on CT arterial portography had lower attenuation than on CT during hepatic arteriography in all patients with intrahepatic portosystemic venous shunts. Overall average CT attenuation was 92.2 +/- 7.7 Hounsfield units (HU) on CT arterial portography and 149.9 +/- 8.5 HU after CT during hepatic arteriography, with the opposite findings in all patients without intrahepatic portosystemic venous shunt: CT attenuation 142.0 +/- 25.7 HU on CT arterial portography and 100.7 +/- 16.4 HU after CT during hepatic arteriography. In conclusion, the portal venous supply to the liver parenchyma decreased due to intrahepatic portosystemic venous shunts, with a compensatory increase in hepatic arterial blood supply.     

Pseudolesions of left liver lobe during helical CT examinations: prevalence and comparison between unenhanced and biphasic CT findings

OBJECTIVE: Localized low attenuated areas (pseudolesions) in the medial segment of left liver lobe are not rarely seen in the screening of abdomen using helical CT. The purpose of this study was to determine the prevalence of pseudolesions in the routine helical CT of abdomen and to evaluate the morphologic and enhancement features of pseudolesions in the unenhanced and enhanced CT examinations. MATERIALS AND METHODS: We retrospectively evaluated 333 contrast enhanced abdominal CT examination of 328 patients with no known liver disease, to detect the presence of pseudolesion of liver. In the presence of unenhanced and arterial phase examinations, these images were also analyzed. The imaging criteria for pseudolesion of liver was localized low attenuated area with geometric, ovoid or nodular shaped and with no mass effect adjacent to the falciform ligament, gallbladder, or porta hepatis. Previous CT, CTAP and MR examinations were also reviewed to understand the evolution of pseudolesion in patients in whom a pseudolesion was detected in the portal phase of helical CT examination. RESULTS: We identified a pseudolesion in the 65 (19.8%) of 328 patients in portal phase of helical CT examinations. Pseudolesions were identified in the medial segment of left liver lobe adjacent to falciform ligament in the 92.8% of patients, both sides of falciform ligament in the 1.5% of patients, adjacent to porta hepatis in the 3% of patients and adjacent to gallbladder 3% of patients. These lesions had triangular shape in the 66.1% of patients, ovoid shape in the 18.6% of patients, and nodular shape in the 15.3% of patients. Unenhanced, arterial and portal phase images were exist in the 50.7% of 65 patients. The pseudolesions were not identified on the unenhanced images in the 75.7% of patients and on the arterial phase images in the 55.6% of patients. CONCLUSION: Pseudolesions around the falciform ligament are not rarely seen in the routine helical CT examination of liver and abdomen. The pseudolesions are more encountered in the portal phase of helical CT examination. These lesions seem to be likely focal fatty infiltration or perfusion defect due to venous supply variation or both. Nodular shaped pseudolesions may be interpreted as true tumors and further study may require for differential diagnosis.     

Pseudolesions of the liver possibly caused by focal rib compression: analysis based on hemodynamic change

OBJECTIVE: The purpose of this study is to show and analyze the CT appearance of pseudolesions of the liver caused by rib compression and to discuss the possible mechanism on the basis of findings of incremental dynamic CT, CT during arterial portography, and CT hepatic arteriography. CONCLUSION: Focal compression of the liver caused by curved ribs can cause transient focal diminishment of portal venous perfusion without significantly altering hepatic arterial perfusion. Such diminishment may be observed as low-density areas on the early phase of incremental dynamic CT.     

The aetiology of non-tumorous enhancement in the hepatic hilum shown on CT hepatic arteriography

The causes of non-tumorous abnormalities in the hepatic hilum seen on CT hepatic arteriography were investigated. 13 patients with non-tumorous defects of portal perfusion in the hepatic hilum on CT arterial portography underwent both CT hepatic arteriography from the common hepatic artery and CT obtained during proper hepatic arteriography. The findings of non-tumorous portal defects on these two angiographic studies using helical CT were compared. In the 13 patients, 14 non-tumorous defects of portal perfusion in the hepatic hilum on CT arterial portography were detected as enhanced areas in 10 regions (dorsum of segment IV, 7/10; dorsum of the lateral segment, 3/4) on CT hepatic arteriography via the common hepatic artery, but none were enhanced on CT obtained during proper hepatic arteriography. In conclusion, the main cause of non-tumorous enhancement in the hepatic hilum seen on CT hepatic arteriography is non-portal direct inflow via the parabiliary venous system.     

Regenerative nodules in liver cirrhosis: findings at CT during arterial portography and CT hepatic arteriography with histopathologic correlation

PURPOSE: To determine the appearance of regenerative nodules in patients with liver cirrhosis at computed tomography (CT) during arterial portography (CTAP) and CT hepatic arteriography (CTHA). MATERIALS AND METHODS: CTAP and CTHA of the liver were performed in 28 consecutive patients with hepatocellular carcinoma (HCC) who were scheduled to undergo partial resection of the liver. Helical CTAP was performed after contrast material injection into the superior mesenteric artery followed by helical CTHA after contrast material injection into the hepatic artery. CT scans were analyzed for the presence of identifiable nodules and their size; results were correlated with gross and microscopic findings. RESULTS: Resected livers showed cirrhosis in 20 patients, chronic hepatitis in four, and normal liver in four. Among the 20 patients with cirrhosis, regenerative nodules were demonstrated as enhancing 3-10 mm nodules surrounded by lower attenuation fibrous septa 0.8-1.5 mm thick at CTAP in seven patients and nonenhancing nodules of the same size surrounded by enhancing fibrous septa at CTHA in 15 patients. The degree of fibrosis determined the conspicuity of nodules. CONCLUSION: Regenerative nodules in cirrhotic liver are visualized as enhancing nodules surrounded by lower attenuation thin septa at CTAP and nonenhancing nodules surrounded by enhancing fibrous septa at CTHA. CTHA is more sensitive than CTAP in depicting regenerative nodules (P < .005).     

Nontumorous Perfusion Abnormalities of Liver Parenchyma Adjacent to the Falciform Ligament As Revealed by Angiographic Helical Ct and Angiography

Purpose: To investigate nontumorous abnormalities in the liver around the falciform ligament as revealed by arteriography and helical CT arterial portography (CTAP) and helical CT during hepatic arteriography (CTHA).Material and Methods: One hundred and seventeen patients simultaneously underwent hepatic arteriography and CTAP and CTHA of the common hepatic artery. The number, size, and shape of nontumorous defects of portal perfusion in the liver adjacent to the falciform ligament on CTAP as well as the nontumorous contrast enhancement in the same area on CTHA were determined. In 1 case, in which nontumorous enhancement was observed on CTHA, selective arteriography from the gastric arteries was performed.Results: On CTAP a nontumorous area of decreased portal perfusion of the liver around the falciform ligament was detected in 18 (15.4%) of the 117 patients, while nontumorous enhancement on CTHA was seen in 7 (6.0%). In 4 patients, both of these nontumorous abnormalities were observed. In the patient undergoing selective gastric arteriography, nonportal venous inflow to the liver in the direction to the liver adjacent to the falciform ligament was seen.Conclusion: One cause of nontumorous vascular abnormalities adjacent to the falciform ligament as shown on angiographic helical CT is aberrant gastric venous inflow to this region.     

Focal hepatic intrinsically hyperattenuating lesions at unenhanced CT: Not always calcifications

Due to the growing use of CT, there has been an increase in the frequency of detecting focal liver lesions. Intrinsically hyperattenuating hepatic lesions or pseudolesions are not uncommon at unenhanced CT. Hyperattenuating hepatic lesions can be divided into non-calcified and calcified.Causes of intrinsic hyperattenuation include hemorrhage, thrombosis, and calcifications. Focal liver lesions can show hyperattenuation on unenhanced CT in case of severe liver steatosis.Recognition of etiologies associated with hyperattenuation on unenhanced CT can help the radiologist in characterizing focal liver lesions and pseudolesions. In this paper, we describe the spectrum of intrinsically hyperattenuating focal liver lesions and pseudolesions at unenhanced CT.     

CT during hepatic arteriography and portography: an illustrative review.

The combination of computed tomography (CT) during arterial portography (CTAP) and CT during hepatic arteriography (CTHA) has been used for evaluation of hepatic neoplasms before partial hepatic resection. Focal hepatic lesions that can be demonstrated with CTAP and CTHA include regenerative nodules, dysplastic nodules, dysplastic nodules with malignant foci, hepatocellular carcinoma, cholangiocarcinoma, hemangioma, and metastases. CTAP is considered the most sensitive modality for detection of small hepatic lesions, particularly small hepatic tumors such as hepatocellular carcinoma and metastatic tumors. CTHA can demonstrate not only hypervascular tumors but also hypovascular tumors and can help differentiate malignant from benign lesions. However, various types of nontumorous hemodynamic changes are frequently encountered at CTAP or CTHA and appear as focal lesions that mimic true hepatic lesions. Such hemodynamic changes include several types of arterioportal shunts, liver cirrhosis, Budd-Chiari syndrome, inflammatory changes, pseudolesions due to an aberrant blood supply, and laminar flow in the portal vein. Familiarity with the CTAP and CTHA appearances of various hepatic lesions and nontumorous hemodynamic changes allows the radiologist to improve the diagnostic accuracy.     

Balloon-occluded arterial portography using prostaglandin E1: Improved visualization of the intrahepatic portal vein

For improved visualization of the intrahepatic portal vein, balloon-occluded superior mesenteric arteriography was performed using a torque-controlled balloon catheter after injection of 20 μg prostaglandin E₁. In patients who underwent arterial portography twice, i.e., by the method using prostaglandin E₁ alone and the prostaglandin E₁ plus the balloon method, the latter method provided better visualization, particularly in cases in which an aberrant right hepatic artery arose from the superior mesenteric artery.     

Non-tumorous enhancement caused by cholecystic venous inflow shown on biphasic CT hepatic arteriography: comparison with hepatocellular carcinoma

The haemodynamics in non-tumorous abnormalities on CT arterial portography (CTAP) owing to cholecystic venous direct inflow to the liver were compared with the haemodynamics in hepatocellular carcinoma. 53 patients who simultaneously underwent CTAP and CT during hepatic arteriography (CTHA) to detect hepatocellular carcinoma had the late phase added to CTHA. Changes in size, shape and pattern of 47 non-tumorous enhancement abnormalities on the liver around the gall bladder or in the dorsum of segment IV between the early and late phases on biphasic CTHA as well as of 60 tumorous lesions were determined. Enhancement on biphasic CTHA was seen in all 47 lesions with a non-tumorous portal defect (early phase alone, n=8; late phase alone, n = 3; both, n = 36). In these 47 lesions, the size and the shape of enhancement changed in 63.8% and 51.1%, respectively, between the early and late phases on CTHA; the pattern of enhancement did not change in 72.3%. On the other hand, the size of enhancement on biphasic CTHA changed in only 16.7% of 60 tumours, and the shape in only 5%, although the enhancement pattern changed in a large proportion (80%). In conclusion, owing to the difference in haemodynamics, non-tumorous abnormalities caused by cholecystic venous inflow and tumours are clearly delineated on biphasic CTHA. Thus, adding the late phase to previous single phase CTHA (i.e. performing biphasic CTHA) is useful in differentiating the two entities.     

Unveiling the unreal: Comprehensive imaging review of hepatic pseudolesions

Hepatic pseudolesions are defined as non-neoplastic focal abnormalities of the liver which can mimic or conceal true liver lesions. It is particularly common in liver due to its unique dual blood supply and the existence of multilevel anastomosis between them. Because of the recent advances in CT and MRI technology, they are being increasingly encountered in daily practice. Broadly they can be categorised in to (1) Focal parenchymal abnormalities like focal fatty change, focal fat sparing, focal confluent fibrosis, segmental hypertrophy and regenerative nodules, (2) Perfusion abnormalities which include transient hepatic parenchymal enhancement in portal vein obstruction, third inflow, intrahepatic shunts, hepatic arterial occlusion and hepatic venous obstruction, (3) Imaging pitfalls like parenchymal compression, unenhanced vessels and pseudolipoma. It is essential for the radiologists to be familiar with the typical and atypical imaging features of pseudolesions to avoid mistaking them for sinister pathologies and also to avoid overlooking underlying hidden pathologies.     

Portal-hepatic venous malformation: Ultrasound,computed tomographic,and angiographic findings

A 59-year-old woman was evaluated for a mass in the right lobe of the liver. Ultrasonography (US) demonstrated multiple anechoic areas with enlargement of portal and hepatic veins. These areas were enhanced uniformly after bolus injection of contrast material during computed tomography (CT). The diagnosis of portal-hepatic venous fistula was confirmed by the portal venous phase of a superior mesenteric angiogram.     

Radiological detectability of minute hepatic venous invasion in hepatocellular carcinoma

Objective

To determine if minute hepatic venous invasion in hepatocellular carcinoma (HCC) can be diagnosed radiologically.

Materials and methods

CT hepatic arteriography (CTHA) and CT arterioportography (CTAP) of 95 cases with HCCs were examined. Histopathology after surgery has been the gold standard in all patients. Based on the presence of microscopic portal venous invasion (MPVI) and microscopic hepatic venous invasion (MHVI), the cases were classified into four groups as follows: Group vp0vv0, negative MPVI and MHVI; Group vp1vv0, positive MPVI and negative MHVI; Group vp0vv1, negative MPVI and positive MHVI; Group vp1vv1, positive MPVI and MHVI. An area showing low attenuation on CTAP and high attenuation on CTHA around the tumor was defined as an area of peritumoral hemodynamic change (APTHC). The shape and size of APTHC were compared between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0. The ratio of APTHC volume to tumor volume (RAT) was employed as an indicator of APTHC size. Each comparison was also made independently when tumor diameter was limited to either less than 3 cm or 3 cm or more.

Results

Three types of APTHC were identified: wedge-shaped, belt-shaped or irregular, and linear. No significant difference in the frequency of each type of APTHC was observed between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0. There was no significant difference in RAT between Groups vp0vv1 and vp0vv0 or between Groups vp1vv1 and vp1vv0, unrelated to tumor size.

Conclusions

The presence of minute hepatic venous invasion in HCC is difficult to determine even on combined CTHA and CTAP.     

Impact of multidetector CT hepatic arteriography on the planning of chemoembolization treatment of hepatocellular carcinoma.

OBJECTIVES: We examined the impact of the increased sensitivity for hypervascular masses of multidetector CT hepatic arteriography on treatment decisions involving selective chemoembolization of hepatocellular carcinomas. SUBJECTS AND METHODS: Thirty patients were referred for chemoembolization of unresectable hepatocellular carcinoma. Initial selective chemoembolization plans were formulated on the basis of diagnostic biphasic CT or MR imaging. Ultrafast CT hepatic arteriography was performed using a multidetector CT scanner and selective contrast material injection into the hepatic artery. The entire liver was scanned in a single breath-hold of approximately 20 sec with a slice thickness of 1 mm. Lesions and their arterial supplies were identified, and these data were immediately used to formulate a final plan for chemoembolization. RESULTS: Hypervascular masses were detected in 29 patients. In 16 (53%) of the patients, preprocedural CT or MR imaging underestimated the number of lesions. In nine (30%) of these 16 patients, the additional lesions were detected only on CT hepatic arteriography, not on conventional angiography. CT hepatic arteriography findings had a major impact on planning the way in which chemoembolization treatment was performed. In three of the nine patients, the previously undetected lesions were treated with additional superselective chemoembolization. In the other six patients, chemoembolization was performed less selectively than originally planned. CONCLUSION: Primarily because of the high sensitivity of multidetector CT hepatic arteriography in revealing small and multifocal hepatomas, findings of this modality frequently alter treatment plans involving selective administration of chemoembolic material.     

应用DSA、CT和经肠系膜上动脉门静脉灌注CT成像研究肝转移瘤的血液供应

目的 探讨DSA、CT和经肠系膜上动脉门静脉灌注CT成像对肝转移瘤的血液供应显示状况.方法 回顾性分析100例原发病灶经手术和(或)病理证实的肝转移瘤患者资料,均进行了CT平扫、多期CT增强扫描、选择性腹腔动脉和超选择性肝固有动脉DSA检查,其中,56例还经肠系膜上动脉插管行肠系膜上动脉的门静脉灌注CT成像(P(1TAP)检查,计算转移瘤中心区域、肿瘤边缘、门静脉和正常肝实质的时间-密度曲线(TDC)灰度密度(K值),观察肝转移瘤血液供应来源.DSA图像用Photoshop软件进行定量分析,CT图像用去卷积灌注软件进行分析.结果 DSA表现:肝固有动脉造影TDC显示肿瘤中心K值峰值平均为(67±12)%,肿瘤边缘K值峰值平均为(76±15)%,正常肝实质K值峰值平均为(51±10)%.腹腔动脉造影TDC显示,肿瘤中心及肿瘤边缘K值表现为快速上升,然后为缓慢上升的平台,而正常肝实质则呈现持续缓慢上升的态势.PCTAP扫描表现:肿瘤在30 s的时间内,密度变化几乎呈直线,无增强表现.结论 肝动脉是肝转移瘤的主要血液供应来源,门静脉几乎不参与肝转移瘤血液供应.     

绞窄性肠梗阻的螺旋CT增强扫描征象分析

目的:分析螺旋CT增强扫描图像上绞窄性肠梗阻的征象,提高对绞窄性肠梗阻术前诊断的准确性.方法:64例手术证实的绞窄性肠梗阻病例纳入研究,男43例,女21例,年龄23～72岁,平均42岁.采用单排螺旋CT进行全腹部扫描,对比剂以2～3ml/s速度注射,注射后60s扫描,层厚10mm.参照术中所见,回顾性分析上述CT资料,包括:①间接征象:肠腔扩张积液,肠壁增厚及肠壁密度改变(靶征),肠系膜脂肪水肿及渗出(缆绳征),肠系膜血管增粗并肠系膜扭曲(漩涡征),肠壁间、肠系膜间及门静脉积气,腹水;②直接征象:肠系膜上动脉或上静脉充盈缺损.结果:正确诊断54例,正确率82.8％.CT显示肠腔扩张积液47例(73％),其中6例积液呈高密度提示肠腔内积血(9.3％);肠壁水肿增厚19例(29.6％),其中11例增强后肠壁密度不匀,呈“靶征”(17％),8例肌壁未见强化(12.5％);肠系膜脂肪水肿及渗出(缆绳征)43例(67％),肠系膜血管增粗并肠系膜扭曲呈“漩涡”状9例(14％),肠壁间积气、肠系膜积气各1例,门静脉积气2例,腹水31例(48.4％).肠系膜上动脉或上静脉充盈缺损3例.结论:绞窄性肠梗阻CT表现有一定特征,可做出提示性诊断.