双源CT血管成像诊断急性肠系膜缺血价值

目的探讨双源CT血管成像（dual—sourceCTangiography，DSCTA）在急性肠系膜缺血（acutemesentericischemia，AMI）诊断中的价值。方法回顾性分析14例经手术或介入治疗证实AMI患者的DSCTA影像资料。结果14例患者中肠系膜上动脉栓塞2例，肠系膜上动脉血栓形成6例，肠系膜上静脉血栓形成3例（1例合并门静脉血栓），肠系膜上动脉重度狭窄1例，表现为血管突然中断，管腔内充盈缺损，管壁增厚，管腔变小，钙化影；肠系膜上动脉夹层2例，显示为真假双腔，内膜片清晰。间接征象为不同程度肠腔扩张，肠管内气液平，肠壁增厚或变薄，腹腔积液。增强扫描时肠壁不强化或强化延迟、减弱。结论DSCTA可准确显示AMI直接征象，是较理想的影像学检查方法。

Value of dual-source CT angiography to the diagnosis of acute mesenteric ischemia

Objective To explore the value of dual-source CT angiography （DSCTA） to the diagnosis of acute mesenteric ischemia （AMI）. Methods The DSCTA data were retrospectively analyzed in 14 patients with surgically or interventionally confirmed AMI. Results Of all these patients, there were 2 patients with superior mesenteric artery （SMA） embolism, 6 with SMA thrombosis, 3 with superior mesenteric vein （SMV） thrombosis （1 patient was complicated with portal vein thrombosis） and l with severe SMA stenosis, showing abrupt termination of artery, intraluminal filling defect, wall thickening or lumen with calcification. SMA dissection in 2 patients showed true and false lumen divided by the intimal flap. The indirect signs were bowel dilatation, air-fluid levels, thickening or thinning of bowel wall and ascites. Enhanced scan showed no enhancement, delayed and weakened enhancement. Conclusions DSCTA can quickly and accurately display the direct signs of AMI, and is an ideal method of imaging diagnosis.