多层螺旋CT在成人肠套叠诊断中的应用价值及病因分析

摘要

Objective To discuss the application value of multislice CT in diagnosis of adult intussusception and particular-ly research its accuracy in diagnosis of adult intussusception and primary disease. Methods 52 cases of patients with adult intussusception confirmed by operation in our hospital from April 2008 to April 2015 were retrospectively analyzed, the op-eration method was traditional open surgery and the operative procedures were: pure lesions resection ,partial enterectomy together with lesions, including tumor radical operation covering corresponding mesentery and regional lymph nodes, before operation, the patients were given multislice CT axial thin layer scanning (plain or plain and enhanced) combined with mul-ti-planar reconstruction, CT characteristics of intussusception were analyzed and their primary lesions were searched. Re-sults The operation results showed that 49 cases belonged to antegrade intussusception, 3 cases belonged to retrograde in-tussusception, 26 cases belonged to ileo-colic intussusception, 11 cases belonged to colon-colon intussusception, 12 cases belonged to small bowell- small bowell intussusception and 3 cases belonged to colon-rectum intussusception, the postop-erative pathological diagnosis results showed that 23 cases were benign lesions and 28 cases were malignant lesions, before operation ,there were 47 cases diagnosed with intussusception by CT, and the accuracy rate was 90.38%, there were 38 cas-es correctly diagnosed with primary lesions by CT, and the accuracy rate was 73.08%. Conclusion Multislice CT is of im-portant value to the diagnosis of adult intussusception, which can find its primary lesions and play a guiding role in its di-agnosis and treatment in late stage.%目的 探讨多层螺旋CT在成人肠套叠诊断中的应用价值, 着重研究其对成人肠套叠及其原发病诊断的准确性.方法 该研究整群选取并回顾性分析该院2008年4月—2015年4月收治并经手术证实的52例成人肠套叠患者;手术方法为传统开腹手术,术式为:单纯病变切除术,连同病变在内的部分肠切除术,包括相应的系膜及区域淋巴结在内的肿瘤根治术. 术前以多层螺旋CT轴位薄层扫描(平扫或平扫+增强)结合多平面重组技术,分析肠套叠CT征象,查找其原发病灶.结果 手术结果显示,有49例属于顺行性肠套叠,3例属于逆行性肠套叠,其中回肠-结肠型肠套叠26例,结肠-结肠型肠套叠11例,小肠-小肠型肠套叠12例,结肠-直肠型肠套叠3例.术后病理诊断结果显示,良性病变23例,恶性病变28例. 术前CT诊断肠套叠47例,准确率为90.38%,正确诊断出原发病变38例,准确率为73.08%. 结论 多层螺旋CT对于成人肠套叠诊断具有重要价值,能够发现其原发病变,对于其后期诊治起着指导意义.