粪石性小肠梗阻MDCT诊断价值.docVIP

粪石性小肠梗阻MDCT诊断价值[摘要] 目的 评估MDCT对粪石性小肠梗阻的定位、定性诊断价值。方法 回顾性分析9例经手术证实的粪石性肠梗阻的临床与CT表现。 结果 多排螺旋CT对肠梗阻的定位诊断准确性为100%，其中位于空肠中段5例，空回肠交界处3例，回肠末端1例。9例定性诊断均准确，主要的CT表现为胶囊样外壳（9/9，100％）、蜂窝样结构（9/9，100％），梗阻近端肠壁增强后表现为靶征（8/9，88.9％），邻近肠系膜浑浊、积液（6/9，66.7％）。 结论 MDCT对粪石性小肠梗阻术前有较高的定位、定性诊断价值 [关键词] 小肠；X线计算机成像；粪石；肠梗阻 [中图分类号] R574.2 [文献标识码] B [文章编号] 1673-9701（2011）33-73-02 The Value of Multi-row Detector CT in Diagnosis of Bezoar Small Bowel Obstruction HUANH Wei1 WANG Yongren1 PENG Zhiyi2 OU Yanglin3 1.Department of Radiology，Yiwu Traditional Medical Hospital in Zhejiang Province，Yiwu 322000，China; 2. Department of Radiology，the First Affiliated Hospital to Zhejiang University,Hangzhou 310009，China；3. Department of Radiology，the PLA Military 175 Hospital,Hangzhou 363000，China [Abstract] Objective To evaluate the value of multi-row detector CT for diagnosis of qualifying and localizing bezoar small bowel obstruction．Methods Multi-row detector CT（MDCT） features and clinical materials of bezoar small bowel obstruction in 9 cases which confirmed by surgery were retrospectively analyzed. Results The diagnostic accuracy in localizing intestinal obstruction with MDCT was 100％，5 cases located in middle jejunum ,3 cases in the junction of jejunum and ileum and 1 cases in terminal ileum；Nine cases（100％）were diagnosed qualitatively．The main CT findings were as follows：capsule-like high density margin （9/9，100%），the honeycomb-like air bubble shadows in the lesions（9/9，100％），target sign in the adjacent proximal intestinal walls enhanced on contrast enhanced images（8/9，88.9%）, peribowels fatty tissue blur，fluidify sign（6/9，66.7%）. Conclusion Multi-row detector CT plays an important role for qualifying and localizing diagnosis of bezoar small bowel obstruction before operation. [Key words] Small bowel；Tomography X-ray computed；Bezoar； Bowel obstruction 小肠梗阻是放射科急腹症检查中常遇见的腹部问题，而粪石是急性小肠梗阻中一种很少见的原因，粪石性肠梗阻的发生率约占小肠梗阻的4%[1]，但临床术前诊断有一定困难，而其影像学表现却有一定特异性。本文回顾性分析9例经手术证实的粪石性肠梗阻的临床与CT影像资料，旨在提高MDCT（