腹部CT影像中肠扭转的诊断

目的评价肠系膜血管旋涡征在腹部多排螺旋CT图像中的显示率及形态学特点,明确其作为肠扭转的特异性征象的诊断可靠性。方法回顾性分析行全腹部CT平扫和(或)三期增强扫描病例经影像学诊断具有肠系膜血管漩涡征的图像38例,对是否存在肠系膜血管漩涡征、漩涡征形态特点及伴随征象进行诊断分析,结合临床症状、手术结果等病史资料分析漩涡征对肠扭转的诊断价值。结果在38例病例中,CT均能发现肠系膜血管漩涡征,9例出现在肠扭转病例组(23.7%),均伴有较明显的肠管旋转。29例出现在非肠扭转病例组(76.3%),伴随征象包括肠管积液扩张(15例),肠粘连改变(9例),肿瘤性病变(5例),其中3例无伴随征象。结论肠系膜血管漩涡征并非肠系膜扭转的特异性征象,肠系膜血管漩涡征结合临床特征、伴随征象及三维重组图像分析有助于鉴别肠扭转与伴有漩涡征的非肠扭转病例。

The diagnosis of volvulus by CT abdomen images——Diagnostic value of mesenteric vessel whirl sign

Objective To evaluate the detection rate and morphological characteristics of mesenteric vessel whirl sign on abdominal spiral CT images and the diagnostic reliability of volvulus using mesenteric vessel whirl sign as its specific sign. Methods The image of 38 cases diagnosed of mesenteric whirlpool sign by plain and/or enhanced CT scan was retrospectively analysed.Medical history such as clinical symptoms and surgical results was combined to evaluate the diagnosis value of whirlpool sign on the volvulus. Results Whirlpool sign was found in all 38 cases,of which 9(23.7%) were intestinal volvulus with apparent intestinal canal rotation,and 29(76.3%) were non-volvulus,follow sign including massive fluid in the distended bowel(15 cases),ankylenteron(9 cases),and neoplasms(5 cases). Conclusion Mesenteric vessel whirl sign is not specific sign in the diagnosis of volvulus.Analysis of image with whirl sign combined with clinical feature and the igns ontribute to the differential diagnosis of volvulus from non-volvulus.