CAJ | 학술논문

目的：探讨多层螺旋 CT（MSCT）及其后处理技术对肠系膜上动脉栓塞（SMAT）的诊断价值。方法：经 CTA诊断为肠系膜上动脉栓塞及继发性改变的11例患者，均经 DSA 或手术证实。所有病例均行螺旋 CT 增强扫描，并采用多平面重组（MPR）、曲面重组（CPR）、最大密度投影（MIP）、容积再现（VR）等方法进行后处理。对 SMAT 的 CTA 表现及肠系膜、肠管等的继发性表现进行观察分析。结果：11例 CT 增强扫描表现均为肠系膜上动脉增粗和血管腔内充盈缺损。可见肠腔扩张、积气、积液和/或液-气平面7例，肠壁变薄2例，肠壁增厚及强化程度减低或不强化8例；肠系膜水肿5例，肠系膜积液2例；气体集聚2例，分别位于肠壁、肠系膜内及腹腔。结论：MSCT 能够对肠系膜上动脉栓塞及继发病变进行快速、及时、准确地诊断，并能判断肠管缺血的程度，与 DSA 及手术所见相符，是诊断肠系膜血管栓塞性病变的有价值的影像学方法。
목적：탐토다층라선 CT（MSCT）급기후처리기술대장계막상동맥전새（SMAT）적진단개치。방법：경 CTA진단위장계막상동맥전새급계발성개변적11례환자，균경 DSA 혹수술증실。소유병례균행라선 CT 증강소묘，병채용다평면중조（MPR）、곡면중조（CPR）、최대밀도투영（MIP）、용적재현（VR）등방법진행후처리。대 SMAT 적 CTA 표현급장계막、장관등적계발성표현진행관찰분석。결과：11례 CT 증강소묘표현균위장계막상동맥증조화혈관강내충영결손。가견장강확장、적기、적액화/혹액-기평면7례，장벽변박2례，장벽증후급강화정도감저혹불강화8례；장계막수종5례，장계막적액2례；기체집취2례，분별위우장벽、장계막내급복강。결론：MSCT 능구대장계막상동맥전새급계발병변진행쾌속、급시、준학지진단，병능판단장관결혈적정도，여 DSA 급수술소견상부，시진단장계막혈관전새성병변적유개치적영상학방법。
Objective:To study the value of multi-slice spiral CT (MSCT)and post-processing technique in the diag-nosis of superior mesenteric artery thrombosis.Methods:11 cases with superior mesenteric artery thrombosis and the secondary changes found by CTA were verified by DSA and operation.Contrast enhanced CT volume scan and post-proces-sing including multi-planar reformation (MPR),curved planar reformation (CPR),maximum intensity projection (MIP) and volume rendering (VR)were performed in all cases.CT findings and the secondary changes of mesentery and intestinal tract were analyzed retrospectively.Results:Contrast enhanced CT images showed dilatation and filling defects in mesenteric arteries in 11 cases.Dilated,gas-and fluid-filled bowel loop with/without air-fluid levels (n=7),bowel wall thinning (n=2),bowel wall thickening with no enhancement (n=8),mesenteric edema (n=5),mesenteric fluid collection (n=2),pneu-matosis of bowel wall,mesenteric and abdominal cavity (n=2)could be observd.Conclusion:MSCT scan is helpful to make a quick,early and accurate diagnosis of superior mesenteric artery thrombosis and the secondary changes,furthermore the degree of intestinal ischemia.CT findings are consistent with the findings of DSA and operation.