Filippone Antonella, Cianci Roberta, Storto Maria Luigia
Department of Clinical Sciences and Bioimages, Section of Radiology, G. d'Annunzio University of Chieti, SS. Annunziata Hospital, Via dei Vestini, 66013 Chieti, Italy.
Abdom Imaging. 2007 May-Jun;32(3):310-6. doi: 10.1007/s00261-006-9065-4. Epub 2006 Aug 26.
Acute obstruction of bowel is a common reason for presentation to the emergency department. Causes of obstruction are multiple (tumorous, inflammatory, postoperative, or congenital), but the clinical presentation is usually not specific. The abdominal radiographs are sometimes inconclusive, and cause of obstruction is rarely detected. Computed tomography (CT) has been shown to be useful in revealing the site and the cause of obstruction. Although radiologists are skilled in the interpretation of CT scans in the axial plane, the development of multidetector-row CT coupled with fast reconstruction hardware and software has stimulated interest in viewing abdomen in coronal plane. In the evaluation of small bowel obstruction, coronal plane serves as a useful adjunct for the identification of the point of transition from dilated to decompressed bowel. On the other hand, in the evaluation of large bowel obstruction, coronal planes could replace axial images in the evaluation of the site and cause of obstruction, although the best values of confidence level in the diagnosis are reached when interpreting axial combined with coronal images.
急性肠梗阻是患者前往急诊科就诊的常见原因。肠梗阻的病因多种多样（肿瘤性、炎症性、术后或先天性），但其临床表现通常不具有特异性。腹部X线平片有时无法得出明确结论，梗阻原因也很少能被检测出来。计算机断层扫描（CT）已被证明在揭示梗阻部位和原因方面很有用。尽管放射科医生擅长解读轴位平面的CT扫描，但多排探测器CT与快速重建硬件和软件的发展激发了人们对冠状面观察腹部的兴趣。在评估小肠梗阻时，冠状面有助于识别扩张肠段与减压肠段的过渡点。另一方面，在评估大肠梗阻时，冠状面在梗阻部位和原因的评估中可以替代轴位图像，不过在解读轴位图像与冠状面图像相结合时，诊断的置信度能达到最佳值。
