Juchems M S, Aschoff A J
Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Ulm, Deutschland.
Radiologe. 2010 Mar;50(3):246-51. doi: 10.1007/s00117-009-1904-1.
Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases. An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava.Multi-detector computed tomography (MDCT) is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity. Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding.
血管病变是急腹症的罕见病因。如果病因是血管疾病，由于血管病变与高死亡率相关，因此需要快速诊断。必须区分动脉疾病和静脉疾病。肠系膜上动脉闭塞是急性肠系膜缺血最常见的原因，但腹腔内动脉出血也很重要。静脉病变包括门静脉、肠系膜静脉和腔静脉的血栓形成性闭塞。多排螺旋计算机断层扫描（MDCT）是诊断腹部血管疾病的理想方法。使用多期对比方案能够可靠地显示动脉和静脉血管树，并以高灵敏度和特异性检测病变。尽管传统血管造影作为一种诊断工具几乎已被MDCT完全取代，但它在微创干预（例如在胃肠道出血的处理中）中仍然非常重要。
