CAJ | 학술논문

目的：探讨胃肠道血管畸形(GIVM)患者的多层螺旋 CT(MSCT)增强扫描表现,评估 MSCT 增强扫描对其的诊断价值。方法分析本院最终诊断为 GIVW 的 MSCT 增强扫描图像,观察病变血管的部位、起源与走行,结合各种 CT 后处理方法分析病灶的影像特点。结果44例行 MSCT 增强检查的 GIVM 患者阳性26例(59.1%),阴性18例(40.9%)。MSCT 阳性病变中1例(2.3%,1/44)病变呈弥漫分布,1例(2.3%,1/44)病变呈多灶性分布,2例(4.5%,2/44)表现为对比剂外溢,6例(13.6%,6/44)表现为肠壁异常强化伴肠周多发迂曲增粗的血管影,10例(22.7%,10/44)例表现为肠壁局部结节状异常强化,6例(13.6%,6/44)表现为肠周小血管影增多。24例局限形病变中胃壁2例,十二指肠1例,空肠10例,回肠3例,回盲部1例,结肠2例,乙状结肠-直肠5例。结论MSCT 增强检查能准确显示胃肠道血管畸形的部位、范围、形态及影像特点,对指导治疗 GIVW 引起的消化道出血有良好的临床应用价值。
목적：탐토위장도혈관기형(GIVM)환자적다층라선 CT(MSCT)증강소묘표현,평고 MSCT 증강소묘대기적진단개치。방법분석본원최종진단위 GIVW 적 MSCT 증강소묘도상,관찰병변혈관적부위、기원여주행,결합각충 CT 후처리방법분석병조적영상특점。결과44례행 MSCT 증강검사적 GIVM 환자양성26례(59.1%),음성18례(40.9%)。MSCT 양성병변중1례(2.3%,1/44)병변정미만분포,1례(2.3%,1/44)병변정다조성분포,2례(4.5%,2/44)표현위대비제외일,6례(13.6%,6/44)표현위장벽이상강화반장주다발우곡증조적혈관영,10례(22.7%,10/44)례표현위장벽국부결절상이상강화,6례(13.6%,6/44)표현위장주소혈관영증다。24례국한형병변중위벽2례,십이지장1례,공장10례,회장3례,회맹부1례,결장2례,을상결장-직장5례。결론MSCT 증강검사능준학현시위장도혈관기형적부위、범위、형태급영상특점,대지도치료 GIVW 인기적소화도출혈유량호적림상응용개치。
Objective To explore the characteristics of gastrointestinal vascular malformation on contrast-enhanced multi-slice spiral computed tomography(MSCT)and assess the value of MSCT in diagnosis of gastrointestinal vascular malformation.Methods Forty-four patients with the final diagnosis of gastrointestinal vascular malformation were collected and analyzed retrospectively.We summarized the characteristics of contrast-enhanced MSCT in gastrointestinal vascular malformation and evaluated the value of MSCT in the diagnosis of gastrointestinal vascular malformation combined with image reconstructions such as MPR,MIP and VRT. Results Among 44 cases who received contrast-enhanced MSCT examination,18 cases were negative(40.9%),26 cases had positive signs(59.1%).In the 26 cases,1 case with diffuse lesions,1 case with multiple lesions,the others were local-type cases,in which 2 cases were showed contrast medium extravasations,6 cases were not only showed local mural hyper-intensification,but also multi-ple dilated small vessels around intestinal tract,10 cases were showed only local mural hyper-intensification,6 cases were showed only multiple dilated small vessels around intestinal tract.In the 24 local-type cases,lesions located at the stomach in 2 cases,the du-odenum 1 case,the jejunum 10 cases,the ileum 3 cases,the ileocecal junction 1 case,the colon 2 cases,the sigmoid colon-rectum 5 cases,respectively.Conclusion Contrast-enhanced MSCT can show the location,extent,patterns features of gastrointestinal vascu-lar malformation.It is helpful for detection and localization of the gastrointestinal vascular malformation with gastrointestinal bleed-ing.