CT联合MRI在华法林致非创伤性自发性小肠壁内血肿的临床应用

目的探讨CT联合MRI在华法林致非创伤性自发性小肠壁内血肿的临床应用。方法选取14例华法林致非创伤性自发性小肠壁内血肿患者的临床资料,分析影像学表现。结果本组14例患者CT原发征象:1)肠壁增厚;2)肠壁密度增高。CT继发征象:1)肠腔狭窄;2)肠壁积气;3)肠周改变及其他伴发征象。MRI表现:T+1黏膜下层高信号,T+2信号不同程度增高,DWI呈弥漫高或稍高信号,T₂^*呈低信号。治疗情况:未经正确治疗的3例复查均表现为原征象无改善或加重。正确治疗的11例复查,10例原征象减轻或消失。结论对正在接受抗凝治疗的患者,突发腹痛伴凝血功能异常,CT显示肠壁增厚及密度增高、腹腔积血,伴肠腔狭窄、肠梗阻、肠周和肠系膜区积血,高度提示本病可能,MRI上T₁WI呈同心环或弹簧样高信号,DWI呈弥漫高信号,T₂^*呈低信号。

Clinical application of CT combined with MRI in warfarin-induced nontraumatic spontaneous intramural hematoma of small bowel

Objective To explore the clinical application of CT combined with MRI in non traumatic spontaneous small intestinal intramural hematoma caused by warfarin.Methods The clinical data of 14 patients with non traumatic spontaneous small intestinal intramural hematoma caused by warfarin were examined by CT and MRI.Results The primary CT signs of 14 patients included intestinal wall thickening and intestinal wall density increased.Secondary CT signs included intestinal stenosis and pneumatosis in the intestinal wall and periintestinal changes and other accompanying signs.MRI findings included T₁ submucosa high signal,T₂ signal increased in varying degrees.DWI showed diffuse high or slightly high signal,T₂^* showed low signal.3 cases without correct treatment showed no improvement or aggravation of the original signs.In 11 cases of correct treatment,the original signs decreased or disappeared in 10 cases.Conclusion For patients undergoing anticoagulant therapy,that sudden abdominal pain with abnormal coagulation function,CT showing intestinal wall thickening and increased density,hemoperitoneum,intestinal stenosis,intestinal obstruction,periintestinal and mesenteric hematocele,highly suggested the possibility of the disease.On MRI,T 1WI showed concentric ring or spring like high signal,DWI showed diffuse high signal,and T₂^* showed low signal.