Chen Ming, Li Xuan, Xie Jing-xia
Department of Radiology, the Third Hospital, Beijing,University, Beijing 100083, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2006 Feb;28(1):80-3.
To explore the clinical value of multi-slice spiral CT (MSCT) in diagnosis of acute mesenteric ischemia.
MSCT, including plain scan, the arterial phase scan, and the portal vein phase scan, was performed in 18 patients who were suspected of acute intestinal ischemia. The mesenteric arteries and portal veins were imaged with techniques including volume-rendered technique, multi-planar reconstruction, and maximum intensity projection-thin. All of them were also examined with digital subtractive angiography (DSA). The diagnostic results of MSCT were compared with those of DSA, and the abnormal MSCT findings were analyzed.
Bowel wall thickening, mesenteric edema, and ascites were most commonly seen in venous thromboses, while luminal dilatation and air-fluid levels were commonly seen in arterial embolization. Except that pneumatosis was only seen in transmural infarction, all the abnormal CT findings were found in different patterns and different degrees of ischemia.
The integrated MSCT examination is a valuable tool in diagnosis of acute intestinal ischemia. It can accurately diagnose acute intestinal ischemia and is also useful to assess the degrees of ischemia.
探讨多层螺旋CT（MSCT）在急性肠系膜缺血诊断中的临床价值。
对18例疑似急性肠缺血患者进行MSCT检查，包括平扫、动脉期扫描及门静脉期扫描。采用容积再现技术、多平面重建及最大密度投影薄层技术对肠系膜动脉和门静脉进行成像。所有患者均行数字减影血管造影（DSA）检查。将MSCT诊断结果与DSA结果进行比较，并分析MSCT异常表现。
肠壁增厚、肠系膜水肿及腹水在静脉血栓形成中最常见，而管腔扩张和气液平面在动脉栓塞中常见。除壁内积气仅见于透壁性梗死外，所有CT异常表现均可见于不同类型和不同程度的缺血。
MSCT综合检查是诊断急性肠缺血的有价值工具。它能准确诊断急性肠缺血，对评估缺血程度也有帮助。
