多层螺旋CT增强扫描对闭合性肠和肠系膜损伤的诊断价值

目的探讨多层螺旋CT增强扫描对闭合性肠和肠系膜损伤的诊断价值。方法收集2007年9月至2013年9月我院30例经手术证实闭合性肠和肠系膜损伤患者资料,比较分析手术结果与多层螺旋CT增强表现。结果 30例患者手术结果肠道穿孔12例,其中3例不止1处穿孔,CT诊断肠道穿孔9例(9/12);肠系膜撕裂伴系膜血管断裂出血6例,CT诊断6例(6/6);肠壁及肠系膜血肿10例,CT诊断10例(10/10);肠壁及肠系膜散在多发性点状出血13例,有7例CT诊断肠及肠系膜挫伤(7/13),另外5例无明确阳性发现。其中11例表现为肠和肠系膜多发损伤。结论多层螺旋CT增强扫描对诊断肠和肠系膜损伤有重要价值,并且部分能够判断损伤程度和部位,对临床治疗方式的选择具有重要指导意义。

The Diagnostic Value of the MSCT Enhanced Scan in Closed Bowel and Mesenteric Injury

Objective To investigate the value of multi-slice spiral computed tomography （MSCT） enhanced scan in the diagnosis of bowel and mesenteric closed injury. Methods To Collect 30 patients with bowel and mesenteric closed injury confirmed by surgncal operation from September 2007 to September 2013 in our hospital, and make the comparative analysis on surgical result and MSCT enhanced scanned. Results There were 30 patients among of them, 12 cases with gastrointestinal perforation, including 3 cases of more one perforation, 9 cases was confirmed by the MSCT. 6 cases with rupture of mesentetic vessel, 10 cases of mesenteric hematoma and also intestinal wall hematoma,these was diagnosed by MSCT successfully. Among 13 cases with intestinal wall and mesentery multiple punctuate hemorrhage, 7 cases of mesenteric contusion by MSCT.5 cases were normal.11 cases were intesnnal and mesentenc multiple injuries. Conclusion MSCT enhanced scan plays an important role on diagnosis of the closed bowel and mesenteric injury, and shows the site of injury and degree. It presents important references for the selecting of clinical treatment.