以急性腹痛为主要表现的SLE缺血性肠病的螺旋CT征象

目的探讨系统性红斑狼疮(SLE)所致缺血性肠病的螺旋CT表现.方法回顾性收集23例确诊为SLE、并因急性腹痛而行腹部螺旋CT扫描的病人资料,其中16例为增强扫描.阅片时着重观察肠道和肠系膜(血管)的异常CT表现.结果肠壁肿胀、增厚19例(19/23);12例出现肠壁"靶征"样强化(12/16);肠管扩张16例(16/23);肠系膜肿胀和脂肪密度增高21例(21/23),肠系膜血管充血、增粗18例(18/23),4例肠系膜血管呈"梳状"排列(4/16).其他CT征象包括腹水、胸水、心包积液、肝脾肿大、肾脏异常、腹膜后淋巴结肿等.结论肠壁和肠系膜(血管)的异常改变是SLE缺血性肠病最重要的CT征象.

Spiral CT findings of systemic lupus erythematosis ischemic bowel disease presenting with acute abdominal pain

Objective To investigate the spiral CT findings of ischemic enteropathy in SLE patients presenting with acute abdominal pain. Methods The clinical data and spiral CT imaging data of 23 confirmed SLE patients with acute abdominal pain were retrospectively reviewed, of which 16 had contrast-enhanced spiral CT scanning of the abdomen. Observation was focused on the changes of bowel wall (wall thickness, enhancement pattern, lumen size) and the mesentery (mesenteric edema, engorgement of mesenteric vessels and abnormal vascular arrangement pattern). Results Ninteen patients had intestinal wall thickening (19/23), with the "target sign" in 12 patients (12/16). Bowel lumen dilatation was present in 16 patients (16/23). Mesenteric fat edema with stranding was noticed in 21 patients (21/23); 18 patients had engorgement and prominence of mesenteric vessels (18/23), with comb like arrangement in 4 (4/16). Conclusion Abnormal changes of intestinal wall and mesenteric vasculature are the most common spiral CT findings in SLE ischemic bowel disease.