全腹部多层螺旋CT扫描对肠系膜扭转、肠扭转的诊断价值

目的：总结小肠系膜扭转、肠扭转的多层螺旋CT征象,进一步提高诊断正确率。方法：对63例术前CT诊断为肠系膜扭转、肠扭转的病例资料进行回顾性分析;对所有病例进行全腹部扫描,1.25mm薄层重建,主要利用多平面重组（MPR）、最大密度投影（MIP）等,结合窗宽技术进行动态连续观察,并将CT扫描诊断结果与手术所见进行比较。结果：63例经CT确诊的患者中,58例肠系膜扭转、肠扭转合并肠梗阻经手术确诊,CT诊断与手术确诊符合率为100%,5例为单纯系膜扭转、肠缺血。主要征象有肠系膜血管的＂旋涡征＂（显示率100%）,肠管的＂鸟嘴征＂（35/63）,全部病例均显示不同程度肠系膜增厚、水肿,腹腔积液51例。结论：肠系膜血管的＂旋涡征＂是诊断肠系膜扭转、肠扭转的特异性征象,全腹部多层螺旋CT扫描及重组对该病的显示率极高,对临床及时诊断和手术治疗具有重要意义。

The diagnose value of multi-slice spiral CT scan in mesenteric volvulus and intestinal volvulus

Objective： To describe the characters of mesenteric volvulus and intestinal volvulus, and improve diagnostic accuracy. Methods： Sixty-three cases of patients diagnosed as mesenteric volvulus or intestinal volvulus were taken for retrospective analysis. All cases were taken with full abdominal scan and 1.25 mm thin-layer reconstruction. It main used multiplanar reformation （MPR）, maximum intensity projection （MIP） techniques such as dynamic window width for continuous observation. The results of diagnosis of CT scan and surgical findings were taken for comparison. Results： There were 58 cases of patients with mesenteric torsion complicated with obstruction by CT in the 63 cases diagnosed, the rate of diagnosed by surgery CT diagnosis and surgical diagnosis line was 100%, 5 cases were with pure mesangial reverse, intestinal ischemia. The major signs were mesenteric blood vessels the ＂whirlpool sign＂ （display rate of 100%） and bowel＇s ＂beak sign＂ （35/63）. All patients had shown varying degrees of mesenteric thickening, edema, ascites （51 cases）. Conclusion： The mesenteric vascular ＂vortex sign＂ is a specific signs for diagnosis of mesenteric torsion. The volvulus of the of the whole abdomen and restructuring of multi-slice CT scan shows the high incidence of the disease, is important for the clinical diagnosis and timely surzical treatment.