目的探讨多层CT在 诊断原发性 急性肠系膜缺血中的临床价值。方法 回 顾性收集临床及CT资料完整的原发性急性 肠系膜缺血患者资料共计27例。所有患 者均经临床和/或手术证实，并行全腹部 CT平扫及动脉期和门静脉期扫描。影像重 点分析包括：肠系膜血管受累部位、CT表 现、相应肠管表现及其他继发表现，如腹 水、系膜改变等。结果 27例患者中，肠 系膜上动脉血栓形成栓塞3例, 肠系膜下 动脉血栓形成1例，肠系膜上静脉血栓形 成23例，CT表现为血管腔内充盈缺损。间 接征象包括：肠腔扩张积液19例、肠壁水 肿增厚15例、肠系膜水肿、密度增高15 例、腹腔积液6例。结论 多层CT对诊断原 发性急性肠系膜缺血有非常重要的临床价 值，能明确血管病变的部位、范围和程 度。

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.