肠系膜上动脉病变致缺血性肠病的MSCT诊断

摘要

Objective To provide the basis for early diagnosis, imaging of ischemic bowel disease caused by superior mesenteric artery disease was analyzed with multi-slice spiral CT retrospectively.Methods 6 cases of intestinal ischemia from August 2012 to August 2015 in this hospital onifrmed by clinical were collected, multi-slice spiral CT was proceed for a full abdominal CT scan, among of them 4 cases were enhanced scanning. Superior mesenteric artery was evaluated with cross section original CT image and variety processing technology.Results 3 cases of 6 patients were acute intestinal ischemia, with clinical manifestations of acute abdominal pain, and all 3 cases were superior mesenteric arterial thrombosis. CT enhancement scan shows thrombosis of the superior mesenteric artery with intraluminal iflling defects. Mild to moderate narrowing were seen, degree of stenosis was between about 50%.The other 3 cases of chronic intestinal ischemia were characterized by chronic abdominal pain associated with eating, with long distance or local calciifcation stenosis of superior mesenteric artery. 2 cases of 6 occurred in mild cases of intestinal obstruction, with intestinal gas lfuid expansion and thickening blur.6 cases of patients with non-surgical treatment have curative effect.Conclusion MSCT can give clear early diagnosis of ischemic bowel disease caused by superior mesenteric arterial lesions, which is important for guiding signiifcance for clinical treatment.%目的：回顾性分析多层螺旋CT在肠系膜上动脉病变致缺血性肠病的影像表现，为临床早期诊断提供依据。方法收集2012年8月至2015年8月在本院行CT检查并经临床证实的肠缺血患者6例，采用多层螺旋CT进行全腹CT扫描，其中4例增强扫描。以横断面原始CT图像加多种后处理技术进行肠系膜上动脉成像评价。结果6例患者中3例急性肠缺血，临床表现急性腹痛，3例均为肠系膜上动脉血栓，CT增强扫描显示肠系膜上动脉血栓，管腔内充盈缺损，轻度、中度狭窄，狭窄度介于50%左右。慢性肠缺血3例，表现为与进食有关慢性腹痛，肠系膜上动脉长段或局限性钙化狭窄。6例中2例发生轻症肠梗阻，肠管积气积液扩张，肠壁增厚模糊。6例患者临床非手术治疗，疗效明显。结论螺旋CT可以明确肠系膜上动脉病变致缺血性肠病的早期诊断，对临床治疗具有重要指导意义。