16层螺旋CT肠系膜上动静脉成像诊断小肠扭转的初步研究

目的探讨小肠扭转时肠系膜上动、静脉的CTA表现及其诊断价值。方法回顾性分析经手术证实的5例小肠扭转病人的肠系膜上动、静脉CTA表现。使用Siemens 16层螺旋CT,于工作站重建肠系膜上动、静脉最大密度投影(MIP)及容积再现(VR)图像。分析肠系膜上动、静脉CTA对于小肠扭转的诊断价值。结果5例病人均清晰显示肠系膜上动脉主干,但远级分支模糊。2例表现为肠系膜上静脉主干远段的扭曲,3例表现为肠系膜上静脉不同属支的扭曲及走行异常,走行异常的血管均与扩张小肠袢位置相吻合。1例见肠系膜上静脉主干的轴向扭曲。2例显示走行异常的肠系膜上静脉属支增粗。5例病人均正确诊断小肠扭转。结论肠系膜上静脉或其属支的扭曲为小肠扭转主要的CTA表现,行肠系膜上动静脉CTA对小肠扭转具有确诊价值。

CT Angiography of Superior Mesenteric Artery and Vein using 16-slice Helical CT in Diagnosing Small Bowel Volvulus:Preliminary Report

Objective To preliminarily describe CT angiography(CTA)findings of superior mesenteric artery(SMA)and superior mesenteric vein(SMV)in patients with small bowel volvulus(SBV)and its diagnostic value.Methods CTA findings of SMA and SMV in 5 patients with surgically proved SBV were retrospectively reviewed.CTA was performed using Siemens 16-slice helical CT.Maximum intensity projection(MIP)and volume rendering(VR)images of SMA and SMV were acquired on a workstation.The efficacy of CTA of mesenteric vascular in diagnosing SBV was evaluated.Results Obvious opacification of SMA was seen in all 5 cases with its dismal branches obscure instead.In 2 cases,tortuosity and abnormal distribution of dismal part of SMV were observed,while that of various dismal tributaries of SMV was presented in 3 other patients with a correlation between abnormal vasculature and location of dilated small bowel loops.Axially torsion was also observed in 1 case.Dilation of tributaries of SMV was seen in 2 patients.All 5 patients were correctly diagnosed.Conclusion Tortuosity of SMV or its tributaries is the main CTA findings in patients with SBV,and SBV can be confirmed using CTA of SMV and SMA.