MSCTA在肠系膜上动脉病变所致老年缺血性肠病诊断中应用.docVIP

MSCTA在肠系膜上动脉病变所致老年缺血性肠病诊断中应用 　　[摘要] 目的 评价多层螺旋CT血管成像（MSCTA）诊断肠系膜上动脉（superior mesenteric artery，SMA）病变所致老年缺血性肠病的价值。 方法 回顾性分析24例经临床确诊的老年缺血性肠病患者的MSCTA图像，采用容积再现（VR）、多平面重建（MPR）、最大密度投影（MIP）及曲面重建（CPR）等多种后处理重建方法分析SMA病变、肠壁及其他腹部影像学特点。 结果 急性肠系膜缺血11例，临床表现为急性腹痛，MSCTA直接征象为SMA管腔内低密度充盈缺损。慢性缺血13例，表现为与进食有关的慢性腹痛，MSCTA表现为SMA多发或局限性钙化斑块。常见的CT间接征象包括肠壁厚度、肠壁强化减弱、肠腔扩张。肠壁积气、肝静脉及门静脉积气为晚期征象。 结论 MSCTA能显示SMA病变类型、肠道及其他腹部异常表现，为缺血性肠病的早期诊断提供有力的依据。 　　[关键词] 老年；肠系膜上动脉；缺血性肠病；体层摄影术；X线计算机 　　[中图分类号] R445.3 [文献标识码] B [文章编号] 1673-9701（2018）01-0115-04 　　Application of MSCTA in diagnosis of ischemic enteropathy in the elderly caused by superior mesenteric artery disease 　　FU Fengli1 LIN Yufang2 JI Danyan1 CHEN Qing1 LIU Tie1 ZHANG Jianjun1 　　1.Department of Radiology，Zhejiang Hospital，Hangzhou 310013，China； 2.Department of Acupuncture，Zhejiang Hospital，Hangzhou 310013，China 　　[Abstract] Objective To evaluate the value of multi-slice spiral CT angiography（MSCTA） in the diagnosis ischemic enteropathy in the elderly caused by superior mesenteric artery disease. Methods The MSCTA images of 24 cases of clinically diagnosed senile ischemic enteropathy were retrospectively analyzed. A variety of post-processing reconstruction methods including the volume reconstruction（VR）， multiplanar reconstruction（MPR）， maximum density projection （MIP） and curved planar reformation were used to analyze the SMA lesions， intestinal wall and other abdominal imaging features. Results There were 11 cases of acute mesenteric ischemia， with the clinical manifestations of acute abdominal pain. MSCTA direct sign was low-density filling defect in SMA lumen. There were 13 cases of chronic ischemia manifested as eating-related chronic abdominal pain. MSCTA showed multiple or localized SMA calcified plaque. Common indirect CT signs included the thickness of the intestinal wall， the weakening of intestinal wall enhancement and intestinal expansion. The advanced signs were intestinal wall product gas， hepatic veins and portal vein gas. Con