肠系膜血管漩涡征在腹部CT影像中的诊断价值.docVIP

肠系膜血管“漩涡征”在腹部CT影像中的诊断价值 毛芸1 ，范晓2，李咏梅1，罗天友1 (1重庆医科大学附属第一医院放射科,2重庆医科大学附属儿童医院放射科 400016) 摘 要：目的 评价肠系膜血管“旋涡征”在腹部多层螺旋CT图像中的显示率及形态学特点，明确其作为肠扭转的特异性征象的诊断可靠性。方法 回顾性分析626例行全腹部CT平扫及双期增强扫描病例图像。以肠系膜血管伴或不伴肠管绕轴旋转角度至少大于90o作为“漩涡征”的判断标准，由2名经验丰富的医师对是否存在肠系膜血管“漩涡征”、“漩涡征”形态特点（位置，旋转方向，旋转角度，旋转段血管起止点间直线距离，旋转半径）及伴随征象进行评估,并比较肠扭转及非肠扭转病例组中“漩涡征”各项特征的差异性。结果 在626例病例中，CT发现72例肠系膜血管“漩涡征”，其中64例出现在非肠扭转病例组（显示率约10.4%），8例出现在肠扭转病例组（显示率约88.9%）。所有8例肠扭转病例的肠系膜血管“漩涡征”均伴有肠管“漩涡征”，6例伴肠系膜上动脉狭窄。非肠扭转病例“漩涡征”中仅2例伴肠管“漩涡征”，无1例肠系膜上动脉狭窄。肠系膜血管“漩涡征”在肠扭转及非肠扭转病例组间比较结果显示旋转角度及旋转段血管起止点间直线距离存在统计学差异。结论 虽然肠系膜血管“漩涡征”并非只特异性出现在肠扭转病例，但通过其形态学特征及三维重建图像分析不难与其它疾病相鉴别。 关键词： 肠扭转；肠系膜；体层摄影术，X线计算机 The diagnostic value of the whirl sign of mesenteric vessels in abdominal CT scan MAO Yun1, FAN Xiao 2, LI Yong-mei1 , LUO Tian-you1 (1The First Affiliated Hospital of Chongqing Medical University, 2The Childrens Hospital of Chongqing Medical University, Chongqing,China) 【Abstract】 Objective To determine the sensitivity of the whirl sign of mesenteric vessels as a specific sign of intestinal volvulus through assessing its frequency and morphologic characters on spiral CT. Methods Two radiogistso retrospectively reviewed all full abdominal CT scans in 626 patients.The diagnostic standard is that the mesenteric vessels must partly or entirely encircle, creating a whirl appearance of at least 90 degrees in CT scans.The features of the whirl sign---the number of degrees of whirl rotation,direction of otation,distance of rotation，semidiameter of rotation ---and other accompanying signs recorded.In addition,some features of whirl sign between volvulus group and non-volvulus group were compared.Results The frequency of whirl sign of mesenteric vessels in volvulus group and non-volvulus group was 88.9%，10.4%，respectively.The readers found all whirl signs of mesenteric vessels in association with rotation of intestine in volvulus group,while 6/8 whirl signs in association with narrowed superior mesenteric artery.On the other hand, only 2 cases with rotation