成人肠套叠的螺旋CT诊断价值

目的:探讨螺旋CT对成人肠套叠的诊断价值.方法:回顾性分析经手术后病理证实的54例成人肠套叠的CT表现资料.结果:54例成人肠套叠的原因分别为:恶性病变包括结肠癌15例,淋巴瘤5例,转移瘤1例,共21例;良性病变包括脂肪瘤30例,平滑肌瘤2例,结肠息肉1例,共33例.表现为小肠-结肠套叠22例,小肠型肠套叠5例,结肠-结肠型肠套叠27例.CT直接征象:靶征48例,彗星尾征3例,肾形征3例,其间肠系膜脂肪套入形成半月形或环形征象35例,如套入部与鞘部肠壁间的气体则形成偏心或外周气泡18例;间接征象;肠壁增厚47例,近侧肠腔不同程度的扩张40例,肠梗阻39例,邻近肠系膜或筋膜浸润21例.结论:肠套叠的CT表现较有特征性,其原发病变CT检出率较高,对脂肪瘤等尚可作出可靠的定性诊断.因此,CT检查是成人肠套叠较理想的影像诊断手段.

Diagnostic value of spiral CT in adult intussusception

Objective：To study the diagnostic value of spiral CT in adult intussusception.Methods：The clinical data of 54 cases of adult intussusception verified by postoperative pathologic examination were retrospectively analyzed and summarized for the CT manifestations.Results：The causes in 54 cases of adult intussusception were malignant disease in 21 cases, including 15 cases of colon cancer,5 cases of lymphoma, 1 cases of metastatic cancer, and benign diseases in 33 cases, including 30 cases of lipoma, 2 cases of leiomyoma,1 cases of colon polypus.The manifestations showed 22 cases of ileocolonic intussusception,5 cases of small bowel intussusception and 27 cases of colocolonic intussusception.CT direct signs：48 cases of target sign, 3 cases of comet tail sign,3 cases of kidney shape sign,35 cases of semilunar or ring shaped sign caused by mesenteric fat embedding and 18 cases of eccentric or peripheral bubble formed by air in intestinal wall between intussusceptum and sheathing,and the indirect signs：47 cases of thickening intestinal wall, 40 cases of expansion of proximal enteric cavity,40 cases of intestinal obstruction and 21 cases of adjacent mesentery or fascia infiltration.Conclusion：CT performance of intussusception has characteristics.CT has the higher detectable rate on the primary disease of intussusceptum.CT is reliable for qualitatively diagnosing lipoma.Therefore,CT examination is the ideal imagelogical method to diagnose adult intussusception.