急性肠缺血的多层螺旋CT评价

目的 探讨多层螺旋CT（MSCT）诊断急性肠缺血的临床应用价值。方法 对18例可疑急性肠缺血患者行MSCT检查,包括平扫、动脉期和门脉期扫描,采用容积显示技术（VRT）、多平面重建（MPR）和薄层最大密度投影（MIP-Thin）进行动脉和门脉成像,评价缺血肠管出现的异常征象,并将MSCT与数字减影血管造影（DSA）结果进行比较。结果 当肠系膜静脉血栓形成时,肠壁增厚、肠系膜水肿、腹水多见;肠系膜动脉血栓栓塞时,肠管扩张、肠腔内积液积气多见。只见于全层坏死的征象是肠壁积气,其他征象均可见于不同病因、不同程度的肠缺血。MSCT诊断急性肠缺血的结果与DSA一致。结论 MSCT能准确诊断急性肠缺血并明确病因,有助于判断缺血程度。

Assessment of acute mesenteric ischemia with multi-slice spiral CT

Objective To explore the clinical value of multi-slice spiral CT (MSCT) in diagnosis of acute mensenteric ischemia. Methods MSCT,including plain scan,the arterial phase scan,and the portal vein phase scan,was performed in 18 patients who were suspected of acute intestinal ischemia. The mesenteric arteries and portal veins were imaged with techniques including volume-rendered technique,multi-planar reconstruction,and maximum intensity projection-thin. All of them were also examined with digital subtractive angiography (DSA). The diagnostic results of MSCT were compared with those of DSA,and the abnormal MSCT findings were analyzed. Results Bowel wall thickening,mesenteric edema,and ascites were most commonly seen in venous thromboses,while luminal dilatation and air-fluid levels were commonly seen in arterial embolization. Except that pneumatosis was only seen in transmural infarction,all the abnormal CT findings were found in different patterns and different degrees of ischemia. Conclusions The integrated MSCT examination is a valuable tool in diagnosis of acute intestinal ischemia. It can accurately diagnose acute intestinal ischemia and is also useful to assess the degrees of ischemia.