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目的探讨小肠扭转时肠系膜上动、静脉的CTA表现及其诊断价值。方法回顾性分析经手术证实的5例小肠扭转病人的肠系膜上动、静脉CTA表现。使用Siemens 16层螺旋CT,于工作站重建肠系膜上动、静脉最大密度投影(MIP)及容积再现(VR)图像。分析肠系膜上动、静脉CTA对于小肠扭转的诊断价值。结果5例病人均清晰显示肠系膜上动脉主干,但远级分支模糊。2例表现为肠系膜上静脉主干远段的扭曲,3例表现为肠系膜上静脉不同属支的扭曲及走行异常,走行异常的血管均与扩张小肠袢位置相吻合。1例见肠系膜上静脉主干的轴向扭曲。2例显示走行异常的肠系膜上静脉属支增粗。5例病人均正确诊断小肠扭转。结论肠系膜上静脉或其属支的扭曲为小肠扭转主要的CTA表现,行肠系膜上动静脉CTA对小肠扭转具有确诊价值。
Objective To investigate the clinical manifestations and diagnostic value of superior mesenteric artery and venous CTA during small intestine torsion. Methods Retrospective analysis of surgically confirmed 5 cases of small intestine torsion patients with superior mesenteric artery and vein CTA performance. Using Siemens 16-slice Spiral CT, the superior mesenteric artery and vein maximum density projection (MIP) and volumetric reconstruction (VR) images were reconstructed at the workstation. Analysis of the superior mesenteric artery and vein CTA for the diagnosis of small bowel. Results All the 5 patients clearly showed the superior mesenteric artery trunk, but the distant branches were blurred. Two cases showed distortions in the distal part of the superior mesenteric vein, and three cases showed abnormal distortions and abnormalities in different branches of the superior mesenteric vein. Abnormal vessels were all consistent with the position of the dilated small intestine. 1 case of superior mesenteric vein trunk axial distortion. 2 cases showed abnormal walking superior mesenteric vein branches thickening. All 5 patients correctly diagnosed small intestine torsion. Conclusions The distortion of the superior mesenteric vein or its branches is the main manifestation of CTA. The superior mesenteric arteriovenous CTA has definite value for the diagnosis of small intestine.