刊期详情

Head and Neck Imaging订阅

Clinical Value of Multidetector Row CT in the Diagnosis of Primary Acute Mesenteric Ischemia

Author：ZHOU Qian-jing, ZHANG Tao, YAN Wei-hong,et al.

affiliation：1 Department of Radiology,157th Hospital; 2 Affiliated to General Hospital of Guangzhou Military Command of PLA,Guangzhou, Guangdong,510510

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Abstract

Objective To investigate the clinical value of multidetector row CT (MDCT) in the diagnosis of primary acute mesenteric ischemia(PAMI). Methods Twenty-seven cases of clinically confirmed primary acute mesenteric ischemia were retrospectively recruited and their clinical information CT images were collected. All of the 27 patients underwent non-contrast enhanced and contrast-enhanced CT examination. Imaging interpretation were focused on the site of the involved mesenteric vessels and imaging features, as well as on secondary imaging findings including the wall, lumen and enhancement pattern of the affected bowel and mesentery and peritoneal findings. Results Of 27 PAMI cases, 3 were diagnosed as superior mesenteric artery embolism, 1 as inferior mesenteric artery embolism, 23 as superior mesenteric venous thrombosis. The direct CT sign was intravascular filling defect on contrast enhanced CT. The associated indirect CT signs were as follows: bowel dilatation in 19, bowel wall thickening in 15, mesenteric stranding in 15 and ascites in 6. Conclusion MDCT could serve as an important and valuable tool in the diagnosis of primary acute mesenteric ischemia.

【Keyword】Primary Acute Mesenteric Ischemia; Tomography; X-ray Computed; Diagnosis

【Chart number】R543.7；R445.3

【Document Identification Number】A

【DOI】10.3969/j.issn.1672-5131.2015.06.024

Introduction

急性肠系膜缺血(acute mesenteric ischemia, AMI)发病率虽然较低(约占入院病例的1/1000)，但其死亡率极高，可达70%，因此是威胁患者生命的重要急腹症之一[1]。AMI按照病因可分为原发性和继发性 (Primary AMI, PAMI)。继发性AMI主要由非血管性疾病导致，如小肠扭转。原发性AMI由血管性病因导致，可以分为肠系膜动脉栓塞形成、肠系膜静脉栓塞形成和非阻塞性肠系膜缺血。原发性AMI的病情尤其凶险，但早期缺乏特异性症状和体征，因此诊断困难[2,3]。影像学检查，特别是CT在急腹症的诊断中有非常重要的作用。因此，笔者收集27例经临床证实的PAMI的CT资料，分析其特征性影像表现，以提高对PAMI 的CT认识。

Chinese journal of CT and MRI

th13Volume， th 6 Issue 2015Year06Month

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