论著-头颈部
256层CT对孤立性肠 系膜上动脉病变的 诊断价值
作者:叶自青1 王 珏2 范占明2 刘英峰1
所属单位:1.中国科学院大学附属北京怀柔医 影像科 (北京 101400) 2.首都医科大学附属北京安贞医院 影像科 (北京 101400)
PDF摘要
目的 探讨孤立性肠系膜上动脉 病变(isolated superior mesenteric artery lesions,ISMAL)的256层CT的影 像特征。方法 回顾性分析12例ISMAL患 者的影像及临床资料,以平扫横轴位、增 强扫描横轴位、容积再现(VR)、曲面重建 (CPR)、最大密度投影(MIP)等重建方法对 肠系膜上动脉病变进行分析观察,总结其 影像学特征。结果 ISMAL患者平均年龄为 (50.1±2.7)岁,男性9例占75%,女性3例 占25%,男性发生率高于女性。肠系膜上 动脉栓塞(superior mesenteric artery embolism, SMAE)共8例,其中男性5例, 女性3例;肠系膜上动脉夹层(superior mesenteric artery dissection, SMAD) 共4例,均为男性;管腔局部增宽、腔内 充盈缺损是SMAE典型征象;腔内条形低密 度影并双腔的显示是SMAD的典型表现。结 论 256层CT平扫及CTA图像后处理技术可 清晰显示肠系膜上动脉病变,确定其病变 性质,了解其累及范围,为临床诊治提供 有力的影像学依据。
Objective To evaluate the image features of isolated superior mesenteric artery lesion (ISMAL) by using 256 slice CT. Methods The images and clinical data of 12 patients were analyzed retrospectively. Every case was analyzed by the methods of vascular reconstruction, such as plain scan transverse axial, enhanced scan transverse axis, the volume rendering (VR), curved planar reformation (CPR), maximum intensity projection (MIP), and summarize the imaging characterization. Results The average age of ISMAL patients was (50.1±2.7)years old, 9 male (75%), 3 female (25%), the prevalence's of SMAD are higher among men than women. 8 patients were superior mesenteric artery embolism (SAME) including5 male and 3 female. 4 patients were superior mesenteric artery dissection (SMAD), all of them were male. The appearance of SMAE were filling defect in arteries and luminal local broadening. The typical manifestation of SMAD was the double chamber display of the strip and low density shadow in the cavity. Conclusion Superior mesenteric artery diseases could be clearly displayed and diagnosed 256 CT plain scan and CTA post-processing technique, and the involvement extent could be confirmed, which provide strong imaging basis for the clinic.
【关键词】孤立性肠系膜上动脉病变; 256层CT;血管成像
【中图分类号】R44 R81
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.08.015
前言
CT血管造影(computed tomographic angiography,CTA)是诊断 主动脉及其一级分支病变十分有价值的影像学检查手段,特别是256 层CT的出现,大大缩减扫描时间,明显降低对患者的屏气要求,使 血管影像更为清晰[1]。孤立性肠系膜上动脉病变(isolated superior mesenteric artery lesions,ISMAL)是指不合并胸腹主动脉夹层 或栓塞而单独发生于肠系膜上动脉的自发性血管病变,其发生率 较低,主要包括肠系膜上动脉栓塞(superior mesenteric artery embolism,SMAE)和肠系膜上动脉夹层(superior mesenteric artery dissection,SMAD)[2-3],均无特异性临床症状,诊断困难[4]。本文回顾 性分析2012年10月到2015年5月12例ISMAL,总结其影像学特征,以期 为更准确、及时地发现病变,进行临床干预提供影像学依据。
中国CT和MRI杂志
第14卷, 第 8 期
2016年08月
相关文章