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目的:研究多层螺旋CT对急性结肠出血的应用价值。方法:对临床可疑急性结肠出血9例患者行多层螺旋CT检查,采用动静脉双期增强扫描,并结合多层螺旋CT多平面重建、最大密度投影图像分析诊断,部分病例经手术或临床随访证实,部分与DSA对照。结果:9例临床拟诊急性结肠出血患者,多层螺旋CT明确诊断出血部位7例,出血显示率77.7%(7/9)。2例多层螺旋CT未发现出血灶及异常。其中多层螺旋CT明确出血7例中4例行DSA,3例显示出血灶,出血显示率75.0%(3/4),1例表现阴性。多层螺旋CT未见异常的2例,DSA表现阴性。CT显示出血部位:升结肠出血2例,降结肠出血4例,直肠出血1例,其中溃疡2例,肿瘤3例,炎症2例。结论:多层螺旋CT双期增强扫描对急性结肠出血具有重要的临床应用价值。
Objective: To study the value of multi-slice spiral CT in the diagnosis of acute colonic hemorrhage. Methods: Nine patients with clinically suspected acute colonic hemorrhage underwent multislice spiral CT examination. The patients underwent double-phase arterial-venous double-phase contrast-enhanced scan combined with multislice spiral CT multiplanar reconstruction and maximum intensity projection image analysis and diagnosis. Some cases were followed up by operation or clinical follow-up Confirmed, part of the DSA control. Results: Among the 9 patients who were diagnosed as acute colitis, 7 cases were diagnosed by multi-slice spiral CT, and the bleeding rate was 77.7% (7/9). 2 cases of multi-slice spiral CT found no hemorrhage and abnormalities. Among them, DSA was performed in 4 of 7 patients with definite hemorrhage and in 3 of 3 patients with hemorrhage, the rate of hemorrhage was 75.0% (3/4), and 1 patient was negative. Two cases of abnormal multi-slice spiral CT, DSA negative. CT showed hemorrhage site: ascending colon bleeding in 2 cases, descending colon bleeding in 4 cases, rectal bleeding in 1 case, 2 cases of ulcer, 3 cases of tumor, 2 cases of inflammation. Conclusion: Multi-slice spiral CT double-phase enhanced scan of acute colonic bleeding has important clinical value.