中国中西医结合影像学杂志
中國中西醫結閤影像學雜誌
중국중서의결합영상학잡지
CHINESE IMAGING JOURNAL OF INTEGRATED TRADITIONAL AND WESTERN MEDICINE
2014年
2期
130-132
,共3页
肠系膜血管栓塞%急腹症%体层摄影术 ,X线计算机%血管造影术
腸繫膜血管栓塞%急腹癥%體層攝影術 ,X線計算機%血管造影術
장계막혈관전새%급복증%체층섭영술 ,X선계산궤%혈관조영술
Mesenteric vascular occlusion%Abdomen,acute%Tomography,X-ray computed%Angiography
目的：探讨M SC T A对急性肠系膜上动静脉栓塞的诊断价值。方法：回顾性分析13例经临床证实的肠系膜血管栓塞患者的急诊CT 平扫、CTA 及三维重建资料。结果：13例中肠系膜上动脉栓塞（superior mesenteric artery embolism ， SM AE）7例、肠系膜上静脉栓塞（superior mesenteric vein embolism ，SM VE）6例。直接征象：7例SM AE中，平扫见血栓密度影2例，CTA均见充盈缺损；6例SMVE中，平扫见血栓密度影4例，CTA均见充盈缺损。间接征象：13例中肠梗阻5例，腹水6例。SMAE：血管壁钙化5例，薄纸样肠壁改变2例，肠壁水肿增厚强化减弱3例；SMVE：增强扫描管壁环形强化、管径扩张5例，缆绳征4例；受累肠管、肠系膜广泛水肿增厚，增强扫描可呈明显减弱或未强化特点，肝脏门脉期强化减弱不均匀2例；合并门静脉、脾静脉血栓2例。结论：CTA对肠系膜上动静脉栓塞的诊断敏感性较CT 平扫高，对于CT 平扫阴性的患者行CTA检查很有价值。
目的：探討M SC T A對急性腸繫膜上動靜脈栓塞的診斷價值。方法：迴顧性分析13例經臨床證實的腸繫膜血管栓塞患者的急診CT 平掃、CTA 及三維重建資料。結果：13例中腸繫膜上動脈栓塞（superior mesenteric artery embolism ， SM AE）7例、腸繫膜上靜脈栓塞（superior mesenteric vein embolism ，SM VE）6例。直接徵象：7例SM AE中，平掃見血栓密度影2例，CTA均見充盈缺損；6例SMVE中，平掃見血栓密度影4例，CTA均見充盈缺損。間接徵象：13例中腸梗阻5例，腹水6例。SMAE：血管壁鈣化5例，薄紙樣腸壁改變2例，腸壁水腫增厚彊化減弱3例；SMVE：增彊掃描管壁環形彊化、管徑擴張5例，纜繩徵4例；受纍腸管、腸繫膜廣汎水腫增厚，增彊掃描可呈明顯減弱或未彊化特點，肝髒門脈期彊化減弱不均勻2例；閤併門靜脈、脾靜脈血栓2例。結論：CTA對腸繫膜上動靜脈栓塞的診斷敏感性較CT 平掃高，對于CT 平掃陰性的患者行CTA檢查很有價值。
목적：탐토M SC T A대급성장계막상동정맥전새적진단개치。방법：회고성분석13례경림상증실적장계막혈관전새환자적급진CT 평소、CTA 급삼유중건자료。결과：13례중장계막상동맥전새（superior mesenteric artery embolism ， SM AE）7례、장계막상정맥전새（superior mesenteric vein embolism ，SM VE）6례。직접정상：7례SM AE중，평소견혈전밀도영2례，CTA균견충영결손；6례SMVE중，평소견혈전밀도영4례，CTA균견충영결손。간접정상：13례중장경조5례，복수6례。SMAE：혈관벽개화5례，박지양장벽개변2례，장벽수종증후강화감약3례；SMVE：증강소묘관벽배형강화、관경확장5례，람승정4례；수루장관、장계막엄범수종증후，증강소묘가정명현감약혹미강화특점，간장문맥기강화감약불균균2례；합병문정맥、비정맥혈전2례。결론：CTA대장계막상동정맥전새적진단민감성교CT 평소고，대우CT 평소음성적환자행CTA검사흔유개치。
Objective:To explore the applied value of MSCTA in the diagnosis of acute embolism of SMA and SMV .Methods :To analyze the emergent CTA and three-dimensional reconstruction images of 13 cases with acute embolism of SMA and SMV proved by operation and clinic retrospectively .All patients underwent emergent full abdominal plain CT scan and CTA scan ,and the CT scan and CTA were analyzed independently .Results:In 13 cases ,7 cases with SMAE ,and 6 cases with SMVE .Straight-forward signs :2 cases with thrombosis on CT scan in SAME ,all cases with filling defect on CTA ;4 cases with thrombosis on CT scan in SMVE ,all cases with filling defect on CTA .Indirect signs :abdominal effusion(n=6) ,intestinal obstruction(n=5);SMAE (n=7):vessel wall calcification (n=5) ,paper-thin changes of intestinal wall (n=2) ,edema and thickening of the intes-tinal wall with weakened enhance (n=3) .SMVE (n=6):Venous wall ring-sharped enhancement and vascular expansion (n=5) ,vascular“cable”-like changes(n=4) .The involved bowel and mesentery were extensive edema and thickened ,and with ob-vious or weakened enhanced features ,inhomogeneous attenuation in liver parenchyma in portal vein phase (n=2) .Portal vein and splenic vein were involved by thrombus in 2 cases .Conclusion:CTA has higher sensitivity than CT scan on the diagnosis of SMAE and SMVE ,patients with negative signs on CT scan underwent CTA examination is very valuable.
