多层螺旋ct口服低张小肠造影的临床应用研究影像医学与核医学专业论文.docxVIP

1例MSCTE漏诊；发生于回肠(包括回盲部)共5例，2例表现为回肠壁 1例MSCTE漏诊；发生于回肠(包括回盲部)共5例，2例表现为回肠壁 局限性环形增厚，3例为回盲部肿块影，其中1例侵犯升结肠并引起低位小 肠梗阻。小肠淋巴瘤4例，均表现为较长范围的肠壁环形增厚、肠腔不狭 窄，2例可见腹腔腹膜后多发淋巴结增大。小肠间质瘤6例，其中3例表现 为腔内均匀明显强化的软组织肿块影(最大径5cm)，边界较清晰，动脉 期其内可见多发血管影，3例表现为较大囊实性肿块影，其内见较多液化坏 死及气体影。小肠脂肪瘤3例，均表现为小肠内多发结节状脂肪密度影。 小肠炎症性病变共24例，其中克罗恩病4例，均表现为空回肠多节段性肠 壁增厚伴肠壁强化，一例伴有腹腔脓肿形成并侵犯右腹直肌，一例伴有肠 系膜多发小脓肿及肛周脓肿形成；溃疡性结肠炎3例，2例表现为降结肠、 乙状结肠及直肠黏膜异常强化，肌层水肿，浆膜层模糊不清，1例表现为全 结肠连续性肠壁增厚并异常强化，肠系膜增厚且明显强化；肠结核7例，3 例表现为广泛腹膜、系膜增厚呈“腹茧症，小肠被聚集且肠壁弥漫性增厚， 腹腔多发淋巴结增大，环形强化，4例表现为回肠末端、回盲部肠壁增厚、 异常强化，腹腔积液，腹膜增厚；腹型过敏性紫癜5例，3例表现为小肠节 段性肠粘膜增粗、明显强化，肠腔未见狭窄，其中1例合并盆腔积液，1例 表现为回盲部及回肠末端肠壁增厚，腹腔腹膜后多发淋巴结增大，腹膜增 厚，MSCTE误诊为肠结核，l例MSCTE漏诊。一般炎症性疾病5例。肠 结石l例，MSCTE漏诊。肠系膜血管病变7例，包括肠系膜扭转2例，均 不伴有肠壁缺血坏死，肠系膜上静脉及门静脉血栓2例，较长范围小肠壁 缺血坏死，肠系膜上动脉栓塞l例，节段性小肠壁水肿增厚，小肠血管畸 形2例，MSCTE漏诊。结论：小肠肿瘤性病变、炎症性病变及血管性病变 等在MSCTE上具有相对特征性的表现，MSCTE能全面展示小肠腔内外病 变、肠系膜、系膜血管及其他脏器情况，对小肠疾病的诊断具有重要价值。 关键词：小肠疾病；体层摄影术；X线计算机；影像表现。 万方数据 The The clinical application and research of multislice CT hypotonic oral enterography(MSCTE) ABSTRACT Part I The comparition of three different neutral contrast media for MSCT enterography Objective：To analyse and compare me small bowel distention degree differences among the patients which clinically suspected intestinal diseases with oral three different neutral contrast．and to choose the best contrast for the clinicians．Methods：Collected in our hospital clinical suspicion of small bowel disease and no clear bowel obstruction in patients with a total of 60 cases，were randomly divided into three groups，of which 2 5％isotonic mannitol group 20 cases，pure milk group 20 cases，20 cases of pure water group．The 60 patients underwent CT dual phase enhanced SCan．all data were leaded into the independent workstation to built the thin background images after the reorganization，and then to analyse the reconstructed images by two experienced radiologists with blinded principle，judging the distention degree of the whole group of small intestine and every intestines．In the end，all the datas were analyzed stati