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目的探讨多层螺旋CT(MSCT)对肠系膜静脉血栓形成诊断的价值。方法回顾性分析8例诊断为肠系膜静脉血栓形成的平扫及增强MSCT表现,其中1例手术证实。结果8例患者MSCT检查均显示不同程度的腹腔积液,肠系膜周边脂肪密度增高,肠系膜上静脉增宽。7例平扫密度增高,其中2例血栓累及门静脉,5例出现肠管扩张、积气积液,5例出现肠管管壁增厚。增强后,肠系膜静脉管壁环形强化,肠管管壁强化呈“靶征”,1例肠管未见强化。抗凝治疗后,1例血栓基本消失,3例肠系膜静脉建立侧枝循环。结论MSCT增强扫描与三维重建技术相结合能早期发现肠系膜静脉血栓形成,它是一种有效、无创的影像学检查手段。
Objective To investigate the value of multi-slice spiral CT (MSCT) in the diagnosis of mesenteric venous thrombosis. Methods Eight cases of mesenteric venous thrombosis were retrospectively analyzed. One case was confirmed by surgery. Results The MSCT of 8 patients showed different degrees of ascites, increased density of mesenteric peripheral fat, and widened superior mesenteric vein. In 7 cases, the mean density of plaque was increased, including 2 cases of thrombus involving the portal vein, 5 cases of intestinal dilatation and accumulation of fluid and 5 cases of intestinal wall thickening. After enhancement, mesenteric vein wall ring enhanced, intestinal wall enhancement was “target sign”, 1 case of intestinal no enhancement. After anticoagulant therapy, one case of thrombus disappeared and three cases of mesenteric vein established collateral circulation. Conclusion MSCT enhanced scan combined with 3D reconstruction can detect mesenteric venous thrombosis early, which is an effective and noninvasive means of imaging examination.