坏死性小肠结肠炎的影像学表现

目的探讨坏死性小肠结肠炎X线表现,以提高诊断正确率。方法分析66例坏死性小肠结肠炎患儿的X线表现,66例均行腹部平片检查,其中4例行腹部CT平扫,并结合临床表现和有关文献,对其X线特征进行描述。结果坏死性小肠结肠炎早期X线表现为胃泡影增大30例,肠曲充气多、肠腔扩张32例,肠曲充气不良14例,肠间隙增厚模26例,部分肠曲狭窄变细、形态僵直40例,进展期肠壁积气29例,门静脉积气者6例,腹腔积液20例,气腹6例。结论肠壁积气、肝门静脉积气为坏死性小肠结肠炎特征性X线征象。X线腹部平片检查对坏死性小肠结肠炎早期诊断,病变进展的估计及提供手术适应症起着重要作用。

Imaging Findings of Necrotizing Enterocolitis

Objective To investigate the X-ray findings of necrotizing enterocolitis, improve the diagnostic accuracy. Methods The plain films of the abdomen of 66 cases and CT findings of 4 cases with neerotizing enterocolitis in children were analyzed retrospectively. Clinical features and relevant literatures were reviewed to describe the X-ray manifestations. Results The early X-ray findings of 66 cases with necrotizing enterocolitis included： gastric air bubble enlargemens （n = 30）, bowel gas increase and bowel expansion （n = 32）, bowel gas abnormal （n = 14）, interspaces widened and indistinct （n = 26）, localized bowel stenosis and rigidity （n = 40）, and advanced pneumatosis intestinalis （n = 29）, hepatic portal venous gas （n = 6）, abdominal fluid collection （n = 20）, pneumoperitoneeum （n = 6）. Conclusions Pneumatosis intestinalis and hepatic portal venous gas were characteristic X-ray signs of necrotizing enterocolitis. The X-ray plain films of the abdomen played an important role in early diagnosis, estimations of the progress and operation indication of necrotizing enterocolitis.