腹内疝伴肠扭转的螺旋CT诊断

目的:探讨螺旋CT对腹内疝及伴发肠扭转的诊断价值.方法:对10例手术证实的腹内疝病例的CT资料进行回顾性分析,CT检查采用平扫及双期增强,并进行VR、MPR及M1P等后处理.结果:10例腹内疝中,8例有腹部手术史,10例均表现为肠梗阻,8例显示疝口,并有肠聚集、移位、肠系膜血管走形异常.伴发肠扭转7例,显示肠管和血管的“漩涡征”,5例见“鸟喙征”,3例见“同心圆征”,4例出现肠绞窄,表现为肠管强化减弱、肠壁水肿、腹水.结论:螺旋CT增强扫描和多种方法重组对腹内疝伴发肠扭转具有重要的诊断价值,及时诊断对患者的预后具有重要的作用.

The helical CT diagnosis of internal abdominal hernias with volvulus

Objective：To study the helical CT diagnostic value of internal hernias with volvulus.Methods：The CT imaging findings of 10 cases of internal abdominal hernia,which had been proved by operations,were analyzed retrospectively.CT image examination was performed by the plan and double strengthening scan and Volume rendering（VR）,Multi-planar reformation（MPR） and Maximum intensity projection（MIP） were adopted.Results：Among the 10 cases of internal abdominal hernia,there were 8 cases with abdomial surgery histories.Intestinal obstructions were found in all of the 10 cases.Orificium hernialis were observed in 8 cases,which showed bowel clustering and displacement,changes of mesentery vessel.Volvuluses were associated in 7 cases,which manifested the whirlpool-like sign of intestine and vessel.Otherwise,＂beak＂（5 cases）,＂target loop＂（3 cases）,intestinal strangulations were found in 4 cases with reduced enhancement and edema of intestine wall and ascites.Conclusion：The enhanced helical CT scan and multi-image reconstruction method have much important value on diagnosing internal abdominal hernia with volvulus.Timely diagnosis of the patient＇s prognosis has the vital role.