Delabrousse Eric, Sarliève Philippe, Sailley Nicolas, Aubry Sébastien, Kastler Bruno A
Service de Radiologie A, CHU Jean Minjoz, 3 bvd A. Fleming, 25030, Besancon, France.
Emerg Radiol. 2007 Nov;14(6):411-5. doi: 10.1007/s10140-007-0647-4. Epub 2007 Jul 6.
The purpose of this study is to report the computed tomography (CT) features of cecal volvulus and to determine the accuracy of CT in distinguishing the three pathophysiological types of cecal volvulus. The CT studies of ten patients with surgically confirmed cecal volvulus were reviewed. For each patient, CT findings were looked for and recorded. The precise location of the cecum within the abdomen, the presence of an ileocecal twist, and the clockwise or counterclockwise direction of the whirl sign were specifically analyzed. All these results were confronted to the surgical diagnosis retrospectively correlated with the three types of cecal volvulus. According to our classification based on the analysis of the location of the cecum within the abdomen and the presence or the absence of a whirl sign on CT scans, the cecal volvulus was defined as the axial torsion type in four (40%) patients, loop type in four (40%) patients, and cecal bascule type in two (20%). For each patient, the result was in full accordance with the type of cecal volvulus diagnosed at surgery. CT is not only a valuable diagnostic technique in diagnosing cecal volvulus and its complications, but it is also useful in distinguishing the three pathophysiological types of cecal volvulus.
本研究的目的是报告盲肠扭转的计算机断层扫描（CT）特征，并确定CT在区分盲肠扭转三种病理生理类型方面的准确性。回顾了10例经手术证实为盲肠扭转患者的CT研究。对每位患者，观察并记录CT表现。特别分析了盲肠在腹腔内的精确位置、回盲部扭转的存在以及漩涡征的顺时针或逆时针方向。所有这些结果均与手术诊断进行对比，并与三种类型的盲肠扭转进行回顾性关联。根据我们基于盲肠在腹腔内位置分析以及CT扫描上漩涡征的有无所做的分类，4例（40%）患者为轴向扭转型盲肠扭转，4例（40%）患者为袢型，2例（20%）患者为盲肠瓣膜型。对每位患者而言，结果与手术诊断的盲肠扭转类型完全相符。CT不仅是诊断盲肠扭转及其并发症的一种有价值的诊断技术，而且在区分盲肠扭转的三种病理生理类型方面也很有用。
