螺旋CT在小肠梗阻诊断中的价值

目的:探讨螺旋CT在小肠梗阻诊断中的价值。方法:对64例小肠梗阻患者肌注低张剂、口服对比剂后行螺旋CT平扫和增强扫描,并与手术病理结果对照。结果:机械性小肠梗阻59例(其中肠肿瘤17例,炎性病变7例,腹外疝8例,腹内疝5例,肠粘连8例,腹茧症5例,胆石3例,肠套叠3例,肠扭转2例,粪块1例),CT诊断正确55例,诊断符合率93%。麻痹性肠梗阻5例,CT诊断正确3例,诊断符合率为60%。8例绞窄性肠梗阻,7例CT诊断正确,诊断符合率88%。结论:CT判断小肠梗阻的有无以及明确梗阻的部位、原因、程度和肠管缺血具有较高的准确性,是诊断小肠梗阻的可靠方法。

The Value of Spiral CT in the Diagnosis of Small-Bowel Obstruction

Objective:To assess the value of spiral CT in diagnosis of small-bowel obstruction.Methods:Sixty-four(patients) with small-bowel obstruction were examined using unenhanced CT and contrast-enhanced CT scans.The results of CT examination were then compared with the surgical findings in order to evaluate the accuracy of CT in diagnosis of small-bowel obstruction.The oral doses of iodating agent were given to all patients before CT examination.Results:The results of CT and surgical findings were consistent in 55(93%)of 59 cases with mechanical small-bowel obstruction(including neoplasm 17 cases,inflammation 7 cases,external hernia 8 cases,internal hernia 5 cases,adhesion 8 cases,abdominal cocoon 5 cases,gallstone ileus 3 cases,intussusception 3 cases,intestine torsion 2 cases,stool mass 1 case).In 5 case of paralytic(ileus,)the diagnoses for 3 cases(60%) by CT were proved to be correct.As for 8 cases with small bowel strangulation,7(cases)(88%) diagnosed by CT were proved to be correct.Conclusion:From the above findings we are sure that CT examination is valuable in diagnosing the presence of small bowel obstruction and defining its location,cause,extent and ischemia as well.It is a kind of reliable method to be recommended.