多层螺旋CT在成人肠套叠诊断中的应用

摘要

Objective To explore the multi-slice spiral CT(MSCT) direct features of adult intussusception and the diagnostic value of the axial thin-slice(thickness:1. 0 mm;interval:0. 8 mm)CT scan in combination with multiplanar reformation (MPR) in adult intussusception. Methods MSCT direct features of adult intussusception confirmed by operation and pathology in 21 cases were analyzed retrospectively. The diagnostic accuracy of adult intussusceptions and its primary diseases evaluated with both axial thick-slice and axial thin-slice (slice thickness :1. 0 mm, interval :0. 8 mm) in combination with MPR images were compared. Results By the axial thick-slice images only, the direct signs including target signs(n= 6) ,double intestinal signs(n= 5) ,atypical signs(n= 6)such as doggy mouth signs, banana signs and "8" signs, mass signs(n = 4) and vessel involvement signs(n= 10) were showed; 13 (13/21, 61. 9%) adult intussusceptions and 13(13/21,61. 9%)primary diseases were diagnosed accurately before operation. But target signs (n= 14) .double intestinal signs(n=18) ,mass signs (n=3) and vessel involvement signs (n=15) were detected, and 19 (19/21, 90. 5% )adult intussusceptions and 15(15/21,71. 4//o)primary diseases were diagnosed accurately by the axial thin-slice images in combination with MPR images. There was significant difference in the diagnostic accuracy of adult intussusception between the axial thin-slice in combination with MPR and the axial thick-slice images (P<0. 05) ,but there was no significant difference in the diagnostic accuracy of primary diseases (P>0. 05). Conclusion Target sign, double intestinal sign and vessel involvement sign are the specific direct MSCT features in diagnosing adult intussusception. Combining the axial thin-slice and MPR images is of important value in diagnosing adult intussusception.%目的 探讨成人肠套叠的多层螺旋CT(MSCT)直接征象和轴位薄层结合多平面重组技术(MPR)对成人肠套叠及其原发病的诊断价值.方法 回顾性分析经手术和病理证实的21例成人肠套叠的MSCT直接征象,并比较应用轴位薄层结合MPR与单纯应用轴位厚层图像对成人肠套叠及其原发病诊断的准确性.结果 应用轴位厚层显示靶征6例,双肠管征5例,不典型征象如狗嘴征、"8"字征和香蕉征共6例,肿块征4例,血管卷入征10例;确诊肠套叠13例(13/21,61.9%)、原发病13例(13/21,61.9%).采用轴位薄层结合MPR显示靶征14例,双肠管征18例,肿块征3例,血管卷入征15例;确诊肠套叠19例(19/21,90.5%)、原发病15例(15/21,71.4%).轴位薄层结合MPR较轴位厚层对成人肠套叠的诊断准确性差异有统计学意义(P<0.05),但对其原发病的诊断准确性差异无统计学意义(P>0.05).结论 靶征、双肠管征和血管卷入征是成人肠套叠的特异性直接MSCT征象;轴位薄层结合MPR对成人肠套叠的诊断有重要价值,应常规实施.