CAJ | 학술논문

目的：总结口服低张等渗甘露醇法MSCT小肠造影的正常表现。方法：回顾性研究20例在我院行MSCTE患者的影像资料，所有病例经临床及影像学诊断消化系统无明显病变，且排除恶性肿瘤、自身免疫性疾病、肝硬化、心功能衰竭、精神病以及碘过敏。使用Siemens Somatom Sensation 64层螺旋CT和370（370mgI/mL）静脉对比剂进行检查，后处理方法包括：多平面重建(multi-planar reconstruction, MPR)、最大密度投影(maximum intensity projection，MIP)、容积再现技术(volume rendered technique，VRT)、曲面重建法(curved planar reformation, CPR)。由两名主治医师以上的专于胃肠道影像诊断的医师，对正常组病例的肠管充盈直径、肠壁CT值和肠壁厚度进行测量，并对小肠缘系膜动脉血管进行统计。结果：本组正常小肠MSCTE的平均充盈直径为（18.3±3.7）mm，各段肠管之间充盈无差异；正常小肠肠壁平均厚度为（2.3±0.4）mm，各段肠管之间肠壁厚度无差异（P＞0.05）；正常小肠平扫、动脉期、静脉期的CT值分别为（29.1±2.0）Hu、（61.0±2.8）Hu、（79.1±4.7）Hu，同一时相各段肠管之间CT值无差异（P＞0.05），而同一组段各期小肠CT值有差异（P＜0.05）；肠系膜上动脉四级以上分支（小肠缘系膜血管）的显示率为81.7%(49)。结论：MSCT检查能清晰显示小肠壁结构及肠缘血管，对正常小肠MSCTE表现的探讨有助于小肠疾病的诊断与鉴别诊断。
목적：총결구복저장등삼감로순법MSCT소장조영적정상표현。방법：회고성연구20례재아원행MSCTE환자적영상자료，소유병례경림상급영상학진단소화계통무명현병변，차배제악성종류、자신면역성질병、간경화、심공능쇠갈、정신병이급전과민。사용Siemens Somatom Sensation 64층라선CT화370（370mgI/mL）정맥대비제진행검사，후처리방법포괄：다평면중건(multi-planar reconstruction, MPR)、최대밀도투영(maximum intensity projection，MIP)、용적재현기술(volume rendered technique，VRT)、곡면중건법(curved planar reformation, CPR)。유량명주치의사이상적전우위장도영상진단적의사，대정상조병례적장관충영직경、장벽CT치화장벽후도진행측량，병대소장연계막동맥혈관진행통계。결과：본조정상소장MSCTE적평균충영직경위（18.3±3.7）mm，각단장관지간충영무차이；정상소장장벽평균후도위（2.3±0.4）mm，각단장관지간장벽후도무차이（P＞0.05）；정상소장평소、동맥기、정맥기적CT치분별위（29.1±2.0）Hu、（61.0±2.8）Hu、（79.1±4.7）Hu，동일시상각단장관지간CT치무차이（P＞0.05），이동일조단각기소장CT치유차이（P＜0.05）；장계막상동맥사급이상분지（소장연계막혈관）적현시솔위81.7%(49)。결론：MSCT검사능청석현시소장벽결구급장연혈관，대정상소장MSCTE표현적탐토유조우소장질병적진단여감별진단。
Objective:To summarize the normal manifestations of MSCT enterography (MSCTE) with iso-osmia man-nitol at hypotonicity. Methods:Retrospective analysis was made on 20 patients with both normal clinical and imaging diag-nosis and the exclusion criteria includes malignancy, connective tissue disease, liver cirrhosis, heart failure, psychosis and allergic to iodine. Post processing such as MPR, MIP, VRT and CPR was used on Siemens Somatom Sensation 64-slice Spiral CT images with 370 iodine (370mgI/ml). The diameter of filling bowel, CT attenuations and thickness of intestinal wall were measured and superior mesenteric arteries of distal end were counted by two gastrointestinal radiologists. Results:On MSCTE images the average diameter of filling bowel was (18.3±3.7)mm, the average bowel thickness was (2.3±0.4) mm, the average CT attenuation of plain scan, artery phase and portal phase was (29.1±2.0)Hu, (61.0±2.8)Hu and (78.7± 5.0)Hu. There was no notable difference at diameter of filling bowel and bowel thickness among the groups of small bowel (P>0.05). No notable difference was found at the average CT attenuation among the groups of small bowel in every phase (P>0.05), but the difference of CT attenuation at every group was significant among the phases (P>0.05). A display rate of 81.7% (49/60) of the superior mesenteric arteries of distal end was found in all cases. Conclusion:The structure and blood circulation of intestinal wall could be displayed clearly on the images of MSCTE, and the study of the normal manifestations of MSCT enterography was helpful for the diagnosis and differential diagnosis of the small bowel.