肠壁积气的影像学表现.docVIP

精品论文 参考文献 肠壁积气的影像学表现 江晶晶 　　（浙江大学医学院附属儿童医院 310003） 　　【摘要】 目的：探讨肠壁积气X线平片以及CT的影像学表现及临床意义。方法：回顾性分析2009年至2012年本院腹部X线平片及腹部CT发现的10例肠壁积气患者的临床以及影像学资料，探讨肠壁积气的腹部X线平片以及CT的影像学特点及其临床意义。结果：9例腹部X线发现肠壁积气共同特点为沿肠管壁的线状、环状、囊状、泡状透亮影。CT扫描软组织窗及肺窗肠壁积气特征性表现为沿肠壁的线状、环状、泡状气体密度影。10例肠壁积气患者中9例临床确诊为新生儿坏死性小肠结肠炎，另1例为巨结肠患儿。结论：CT对肠壁积气的诊断敏感性及特异性较X线平片高，X线平片应用比较广泛，适合于床边检查，可用于肠壁积气的临床筛查。 　　【关键词】 肠壁积气；X线平片；CT；坏死性小肠结肠炎；巨结肠 　　【中图分类号】R445 【文献标识码】A 【文章编号】2095-1752（2015）22-0026-02 　　Imaging findings of intestinal wall product 　　Jiang Jingjing. The Affiliated Childrens Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou 310003, China 　　【Abstract】?Objective To investigate the computed tomography (CT) and plain X-ray appearances of pneumatosis intestinalis (PI) and its clinical significance. Methods In a retrospective study of ten patients with PI between 2009 to 2012. Plain X-ray and CT appearances, clinical features were discussed. Results Nine patients with PI were diagnosed by plain X-ray, the other one by computed tomography (CT).On plain X-ray radiographs , PI appeared as linear or round or bubble or cystic radiolucencies. Computed tomography (CT) scan in soft-tissue window or in lung window PI appeared as linear or circumferential or bubbly density of the gas shadows. PI was present in nine cases of necrotizing enterocolitis, another one of hirschsprung disease. Conclusion CT had high sensitivity and specificity for diagnosed of PI, X-ray had wide application, suitable for bedside check, clinical can be used for screening. 　　【Key Word】 Pneumatosis intestinalis ; X-ray; Computed tomography; Necrotizing enterocolitis; Hirschsprung disease 　　肠壁积气（pneumatosis intestinalis，PI)是各种原因导致气体在肠管壁异常积聚形成的影像学征象。肠壁积气不是一种独立的疾病，通常是伴随其它疾病出现的一种征象[1]。肠壁积气在成人和儿童均可出现。肠壁积气约15%属于原发性，85%属于继发性[2]。肠壁积气临床较少见，成人一般多见于移植或化疗病人，儿童特别是婴幼儿肠壁积气最常见于坏死性小肠结肠炎(necrotizing enterocolitis,NEC）[1]。本研究通过回顾性分析本院发现的肠壁积气患者影像学及临床资料，探讨肠壁积气的腹部X线平片以及CT表现及其临床意义。 　　1.资料与方法 　　1.1 一般资料 　　10例肠壁积气患