Merine D, Fishman E K, Jones B, Siegelman S S
AJR Am J Roentgenol. 1987 Jun;148(6):1129-32. doi: 10.2214/ajr.148.6.1129.
The CT scans in nine proven cases of enteroenteric intussusception were analyzed. Three different CT patterns were observed: a target lesion (n = 5), a reniform mass (n = 2), and a sausage-shaped mass with alternating layers of low and high attenuation (n = 2). Small-bowel series were available within 2-4 days of CT in eight patients and were positive in five. Surgical proof of intussusception was available in seven of the nine patients. Resected small-bowel specimens from patients with the reniform configuration revealed focal ischemic changes. Other objective parameters of ischemia such as acidosis and hyperamylasemia were also present in the two patients with reniform masses. Such changes were not evident in the other patients. This suggests that intussusceptions with reniform configurations warrant more urgent surgical attention. The varying patterns of intussusception on CT should be recognized so that appropriate management can be initiated.
对9例经证实的小肠套叠病例的CT扫描结果进行了分析。观察到三种不同的CT表现:靶征病变(n = 5)、肾形肿块(n = 2)以及具有高低密度交替分层的腊肠样肿块(n = 2)。8例患者在CT检查后的2 - 4天内进行了小肠造影,其中5例呈阳性。9例患者中有7例经手术证实为套叠。肾形结构患者的切除小肠标本显示有局灶性缺血改变。两名有肾形肿块的患者还存在其他缺血的客观指标,如酸中毒和高淀粉酶血症。其他患者未出现此类明显变化。这表明具有肾形结构的套叠需要更紧急的手术处理。应认识到CT上套叠的不同表现模式,以便启动适当的治疗。