肠扭转的CT诊断简

目的分析肠扭转的CT特征性征象，提高肠扭转的术前CT诊断正确率。方法回顾10例经手术证实的肠扭转腹部CT表现，均为术前全腹CT平扫加增强，并将图像传入工作站进行图像后处理，包括MPR、MIP及CTA。结果10例肠扭转患者中，单纯小肠扭转7例，乙状结肠扭转2例，空肠合并升结肠扭转1例。CT表现为肠管不同程度扩张并长短不一的气液平，肠壁水肿，4例合并腹腔积液，其中特征性CT征象包括：7例单纯小肠扭转患者中5例出现肠管“旋涡征”，6例“血管旋涡征”，4例“靶环征”，3例“鸟喙征”：2例乙状结肠扭转患者均见“鸟喙征”，可见“U字征”1例，“S字征”1例，1例空肠合并升结肠扭转患者可见肠管、血管“旋涡征”及“鸟喙征”。结论肠扭转患者螺旋CT表现具有特征性，结合后处理技术，通常能于术前明确诊断。

CT Diagnosis of Intestinal Volvulus

Objective To analyzed the CT manifestation of intestinal voh, ulus in order to increase the confirmed diagnostic rate of the intestinal volvulus. Method CT findings of 10 patients with surgically proved intestinal volvulus were retrospectively reviewd. CT plain scan, double phase enhancement scan and image postprocessing（MPR, MIP, CTA） were performed in the 10 cases. ,Results In 10 example volvulus patients, 7 cases were the simple enteric volvulus , 2 cases were sigmoid volvulus, 1 case was the jejunum and ascending colon volvulus. The main signs of CT included the different degree dilated intestinum and air fluid level, the edema of intestinal wall, seroperitonemn. The characteristic sign included ＂whirlpool drafts＂ sign in 5 cases, ＂vascular whirlpool drafts＂ sign 6 cases, ＂target loop＂ in 4 cases ,＂beak＂ sign in 3 cases （of the 7 cases of simple enteric volvulus） ; the ＂U＂ sing in1 case and ＂S＂ sign in 1 case of 2 cases of the sigmoid volvulus; ＂whirlpool drafts＂ sign ,＂vascular whirlpool drafts ＂sign and ＂beak＂ sign showed in the jejunum and ascending colon volvulus. Conclusion The CT findings of intestinal volvulns have a certain characteristic features. And a confirm diagnosis can be made by combining with image post-processing technology before surgery.