肠旋转不良伴中肠扭转的CT诊断

目的：研究CT对肠旋转不良伴中肠扭转（volvuhus in intestinal malrotation,VIM)的诊断价值。方法：回顾性分析6例手术证实的VDIM的CT表现。男5例，女1例，年龄7～25岁，平均13岁。结果：6例均表现为肠系膜根部类团块影，其中4例见典型“漩涡征”，2例呈类“靶征”，但增强扫描亦出现“漩涡征”。毗邻部肠袢扩张，肠系膜静脉不同程度淤积扩张，2例伴受累系膜、肠壁重度水肿。6例均见系膜根部肠系膜上动脉（superior mesenteric artery,SMA）、肠系膜上静脉（superior mesenteric vein,SMV)血管正常排列迷失。结论：“漩涡征”伴系膜根部SMA、SMV正常排列迷失为本病的特征性CT表现。

CT diagnosis of volvulus in children and adolescence intestinal malrotation

Objective　To study the CT manifestations of volvulus in intestinal malrotation (VIM) so as to recognize the characteristics of VIM. Methods　Six cases of VIM proved by surgery were reviewed, there were 5 males and 1 female, and the mean age was 13 years. Results　A characteristic CT appearance consisting of multiple dilated intestinal loops with edematous mesenteric folds was found. Mesenteric vessels converging toward the root of superior mesenteric artery (“whirl sign”) was demonstrated in 4 cases. The “target sign”, which also showed “whirl sign” after enhancement was found in 2 cases. Marked venous obstruction with thickening of the involved intestinal segment bowel wall was present in 2 cases. Conclusion　The predominant “whirl sign” with the abnormal arrangement of superior mesenteric artery and veins at the mesenteric root was a characteristic CT finding of VIM.