磁共振小肠造的影对小肠疾病的诊断价值.pdf

作者单位 :310016　杭州 ,浙江大学医学院附属邵逸夫医院消化科 E2mail :dengyanyong @163. net ·论著· 磁共振小肠造影对小肠疾病的诊断价值 邓燕勇 　戴宁 　孙蕾民 　王建国 　章士正 　　【摘要】　目的 　探讨磁共振小肠造影对小肠疾病的诊断价值。方法 　对 21 例疑为小肠疾病的患 者行磁共振小肠造影检查 ,并与小肠插管造影和 (或)手术病理结果比较。结果 　21 例行磁共振小肠造 影检查的患者中 ,20 例与小肠插管造影相符 ,包括克罗恩病 6 例 ,小肠肿瘤 4 例 ,肠梗阻 3 例 ,肠结核 1 例 ,十二指肠结肠瘘 1 例 ,有 5 例经各项检查均未发现小肠有明显病变。另 1 例磁共振小肠造影诊断为 克罗恩病 ,但小肠插管造影误诊为淋巴瘤。磁共振小肠造影与临床诊断符合率为 100 % ,而小肠插管造 影为 95. 2 %。有 8 例行手术治疗 ,结果均与磁共振小肠造影表现相符 ,其中 7 例与小肠插管造影相符。 结论 　磁共振小肠造影对小肠疾病 ,尤其是对肠壁和肠腔外病变的诊断有较高的临床价值。 【关键词】　小肠疾病 ;磁共振小肠造影 ;小肠插管造影 Value of magnetic resonance enteroclysis in the diagnosis of small intestinal diseases 　D EN G Yan2yong , DA I Ning , S UN L ei2ming , et al . 　Depart ment of Gast roenterology , S i r R un R un S haw Hospital , Medical College of Zhejiang U niversity , Hangz hou 310016 , China 　　【Abstract】　Objective 　To evaluate the role of magnetic resonance enteroclysis (MRE) in the diagnosis of small intestinal diseases. Methods 　MRE findings in 21 cases of small intestinal diseases were compared with findings of conventional enteroclysis and/ or surgery. Results 　MRE and conventional enteroclysis were identical in 20 of 21 cases , including Crohn disease in 6 , intestinal neoplasms in 4 , intestinal obstruction in 3 , intestinal tuberculosis in 1 , duodenocolic fistula in 1 , and normal in 5. However , onepatient with Crohn dis2 ease found by MRE was not diagnosed by conventional enteroclysis. The clinical diagnostic coincidence rate of MRE was 100 % , while that of conventional enteroclysis was 95. 2 %. MRE and surgical diagnoses were same in 8 of 8 cases , while conventional enteroclysis and surgical diagnoses were same in 7 cases. Conclusions 　 MRE is a valuable method in diagnosis of small intestinal diseases , especially the diseases involving the bowel wall and extralumen. 　　【Key words】　Small intestinal diseases ; Magnetic resonance enteroclysis ; Conventional enteroclysis 　　小肠疾病虽然在消化道疾病中较常见 ,但诊断 颇为困难 ,目前对小肠疾病的检查方法主要有胃肠 钡餐、小肠插管造影、CT、肠系膜血管造影、小肠镜 等 ,但这些方法均有不足 ,前两者常因肠襻重叠造成 假阴性 ,