多层螺旋CT血管造影及三维重建技术在肠系膜上静脉栓塞诊断中的临床价值

目的:探讨多层螺旋CT血管造影及三维重建技术在SMVT诊断中的临床价值。方法:回顾分析我院2005年1月~2010年5月经手术证实的6例SMVT患者的16层螺旋CTA及三维重建资料,分析其CTA征象,对照术中所见及术后病理判断CTA及三维重建的临床价值。结果:直接征象:①CTA示SMV腔内充盈缺损、血管壁环形强化,本组6例均有显示,其中3例合并门静脉充盈缺损,3例合并SMV属支充盈缺损;②SMV增粗,6例SMV均增粗;③肠系膜上静脉腔内密度增高,本组有4例。间接征象:①肠系膜淤血肿胀4例;②肠管管壁水肿6例;③小肠梗阻征象2例;④腹水3例;⑤门静脉期肝强化不均匀4例。三维重建技术:MPR、MIP、VRT、VE对肠系膜上静脉及栓塞情况均显示良好。结论:多层螺旋CT血管造影及三维重建技术在SMVT诊断中具有重要临床价值,对于早期诊断和筛查具有重要意义。

Clinical value of multislice spiral CT angiography and three-dimensional reconstration in diagnosis of superior mesenteric venous thrombosis

Objective：To explore the clinical value of multislice spiral CT angiography and three dimensional reconstruction in diagnosis of superior mesenteric venous thrombosis（SMVT）.Methods：Retrospective analysis of 6 cases with SMVT which were verified by surgery and pathology between January 2005 and May 2010 in our hospital.All cases had received 16-slice spiral CT angiography examination.Various post-processing three-dimensional reconstruction image were obtained and compared.Results：Direct sign： ① filling defect in SMV and venous wall ring-sharped enhancement were showed in 6 cases.Portal veins and branchs of SMV were involved by thrombus in 3 cases,respectively;② SMV were widened in all cases;③ High density of vein were revealed in 4 cases.Indirect sign： congested and edema of mesentery,intestinal wall thickening,intestinal obstruction,ascites,inhomogeneous attenuation in liver parenchyma in portal vein phase were showed in 4,6,2,3,and 4 cases.MPR,MIP,VRT and VE demonstrated SMVT clearly.Conclusion：Multislice spiral CT angiography and three-dimensional reconstrution play an important role in diagnosis SMVT.