Radiology Department, Criscuoli Hospital, Sant'Angelo dei Lombardi, Avellino, Italy.
Radiology Department, University of Campania Luigi Vanvitelli, Naples, Italy.
Radiol Med. 2019 Feb;124(2):103-108. doi: 10.1007/s11547-018-0947-7. Epub 2018 Oct 27.
The pathogenesis of acute ischaemic colitis depends on two different forms of vascular colonic insult: occlusive injury and non-occlusive injury. Clinically, ischaemic colitis may be classified as two major forms: mild (non-gangrenous) and acute fulminant (gangrenous). The classic presentation is abdominal pain, diarrhoea and/or rectal bleeding, but it is not specific and highly variable and so the diagnosis usually depends on clinical suspicion and is supported by serologic and colonoscopic findings. Imaging methods have their role in diagnosing IC. While plain radiography and ultrasound can orient the diagnosis, CT allows to define the morphofunctional alterations discriminating the non-occlusive forms from the occlusive forms and in most cases to estimate the timing of ischaemic damage. Purpose of the review is to define the role of CT in the early identification of pathological findings and in the definition of evolution of colonic ischaemic lesions, in order to plan the correct therapeutic approach, suggesting the decision of medical or surgical treatment.
阻塞性损伤和非阻塞性损伤。临床上，缺血性结肠炎可分为两种主要形式：轻度（非坏疽性）和急性暴发性（坏疽性）。典型表现为腹痛、腹泻和/或直肠出血，但它不具有特异性且高度可变，因此诊断通常取决于临床怀疑，并通过血清学和结肠镜检查结果得到支持。影像学方法在诊断 IC 中具有其作用。虽然平片和超声可以确定诊断方向，但 CT 可以定义形态功能改变，将非阻塞性形式与阻塞性形式区分开来，并在大多数情况下估计缺血性损伤的时间。本综述的目的是定义 CT 在早期识别病理发现和定义结肠缺血性病变演变中的作用，以便为正确的治疗方法制定计划，建议决定采用药物还是手术治疗。
