系统性红斑狼疮所致缺血性肠病的螺旋CT表现特征

目的：探讨系统性红斑狼疮（SLE）所致缺血性肠病的蚴旋CT表现特征。方法：回顾性分析23例因SLE病人急性腹痛而行腹部螺旋CT扫描检查的临床资料及CT图像,其中增强CT扫描16例,CT平扫7例。着重观察肠道、肠系膜和肠系膜血管的异常CT表现性,同时也记录其它腹部异常征象,如浆膜腔积液、实质性脏器异常、淋巴结肿大等。结果：肠壁肿胀、增厚19例（19／23,82．6％）,肠壁“靶征”12例（12／16,75％）,肠管扩张16例（16／23,69．6％）。肠系膜肿胀和脂肪密度增高21例（21／23,91．3％）,肠系膜血管充血、增粗18例（18／23,78．3％）,肠系膜血管“梳状”排列4例（4／16,25％）。其它CT异常征象包括腹水、胸水、心包积液、肝脾肿大、肾脏异常、腹膜后淋巴结肿等。结论：缺血性肠病是SLE病人出现急性腹痛最主要的病理改变,其肠壁、肠系膜和肠系膜血管是最常见和最重要的异常CT表现。螺旋CT增强扫描是评价SLE缺血性肠病最佳的影像学检查方法。

Spiral CT Features of Ischemic Bowel Disease in Patients with Systemic Lupus Erythematosus

Objective:To evaluate the spiral CT manifestations of the ischemic changes of intestinal tract and its mesentery in patients with Systemic Lupus Erythematosis(SLE).Methods:The clinical data and spiral CT imaging files of 23 confirmed SLE patients with acute abdominal pain were retrospectively reviewed.Sixteen of them had contrast enhanced spiral CT examination of the abdomen,the rest had unenhanced CT study.Emphasis was placed on the changes of bowel wall(wall thickness,enhancement pattern,lumen size)and the mesentery(mesenteric edema,engorgement of mesenteric vessels and their abnormal arragement pattern).Other abnormal findings,such as fluid collection,changes of abdominal solid organs,lymphadenopathy,etc.were also observed.Results:Nineteen patients had intestinal wall thickening(19/23,82 6%),with the "target sign"in 12 patients(12/16,75%),and bowel lumen dilatation was present in 16 patients(16/23,69 6%).Mesenteric fat edema with stranding was noticed in 21 patients(21/23,91 3%);18 patients had engorgement and prominence of mesenteric vessels(18/23,78 3%),and with comb like arrangement in 4(4/16,25%).Conclusion:Ischemic bowel disease was the most common abnormal CT findings in SLE patients with acute abdominal pain,including alterations in bowel wall,mesentery and mesenteric vasculature.Contrast-enhanced spiral CT was the preferred imaging method for the evaluation of ischemic bowel disease in SLE patients.