肠梗阻的CT诊疗策略.ppt

肠梗阻的CT诊疗策略;目 的;何谓肠梗阻 ？;准确的诊断刻不容缓 ！;动力性: 麻痹性、痉挛性;诊断的 关键！;影像医师的任务;Diagnosis of SBO;判断肠管是否异常的标准;机械性肠梗阻;粘连性肠梗阻Adhesive SBO;WW 300 WL 0-10 易于显示粘连带;移行段和粘连带;“Feces sign”提示移行段就在附近！;“Fat notch sign” 提示梗阻点所在;“Fat notch sign”是粘连性肠梗阻的一个重要征象;钡剂造影检查可以清楚地显示移行带位置;肠套叠;Submucosal lipoma associated with small bowel intussusception;粘膜下脂肪瘤;A 54-year-old male complained of abdominal pain for 2 months;Small bowel intussusception;Small bowel intussusception;腹 内 疝;Foramen of Winslow hernia in a 43-year-old male with acute epigastric pain of 10 hours duration. ;Paracolic internal hernia ;Congested mesenteric vessels; 男，71岁，腹胀、腹痛3天;诊断要点;肠道异物Foreign bodies ;1年前;不同的窗宽窗位对异物的显示效果;A 16-year-old female presented with abdominal pain and distention for 5 days;Bezoar胃石 ;Feces sign;肠道异物诊断要点;闭绊性肠梗阻Closed-loop SBO;Closed-loop obstruction is unique form of mechanical bowel obstruction in which two points of intestine along its course are obstructed at single site. C = closed loop, P = proximal loop, D = distal loop. ;闭袢型肠梗阻 ？;a;b;“涡旋征”和“喙征”是肠扭转的典型征象;另一种“喙征”;“U”型肠绊;“C”型肠绊;相对对称的肠管扩张和狭窄段;绞榨性肠梗阻Strangulating SBO ; Strangulating SBO;Acute bowel ischemia 急性肠缺血;Characteristic findings ;Indications of ischemia ;Indications of ischemia; Indications of infarct;Muscularis propria;Systemic lupus erythematosus with mesenteric ischemia in a 20-year-old man. Target sign, mesenteric vascular engorgement and haziness are showed on CE-CT scan.;Peritonitis associated with bowel gangrene;Spoke wheel sign轮辐征;Congested mesenteric veins;血运性肠梗阻;Superior mesenteric vein thrombosis;肠系膜上动脉血栓形成;男，40岁，腹痛并肛门停止排气排便4天;男，58岁，左上腹疼痛1周并血便1天;A 27-year-old male presented with abdominal pain of 10 hours duration;血运性肠梗阻;总 结;诊断原则;足够的耐心和准确的判断力！;Thanks for your attention !