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双源CT低剂量扫描 技术诊断肠系膜缺 血性疾病的价值

作者:罗焕江 赵海波 陈 航 龙腾河

所属单位:广西医科大学第四附属医院放射科 (广西 柳州 545005)

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摘要

目的 探究双源CT低剂量扫描技 术在诊断肠系膜缺血性疾病中的价值。 方法 回顾性分析我院双源CT不同剂量扫 描方案诊断肠系膜缺血性疾病的结果。结 果 两组患者个性参数(性别比、年龄、 BMI)和扫描长度等无明显差异,不具统计 学意义(P>0.05);两组患者图像质量的 主观评分,诊断一致性较高,无明显差异 (P>0.05);观察组患者平均有效辐射剂量 为(2.43±0.76)mSv,对照组平均有效辐 射剂量为(4.21±1.33)mSv,观察组明显 低于对照组(P<0.05),差异具有统计学意 义。以血管造影检查及手术结果为金标准 判断不同剂量扫描方案下影像诊断准确 率,两组诊断肠系膜血管性病变准确率为 100%。结论 双源CT低剂量诊断肠系膜缺 血性疾病具有较高的准确性,同时降低了 辐射剂量,具有推广价值。

Objective To explore the value of dual-source CT low dose scanning technique in the diagnosis of mesenteric ischemic disease. Methods The results of different doses of dual source CT in the diagnosis of mesenteric ischemic disease were retrospectively analyzed. Results There were no significant differences in personality parameters (sex ratio, age, BMI) and scanning length between the two groups (P>0.05). The subjective score of the image quality of the two groups was high, and there was no significant difference between the two groups (P>0.05). The average effective radiation dose was (2.43±0.76) mSv in the control group and (4.21±1.33)mSv in the observation group, The average radiation dose received by the patients in the observation group was significantly lower than that of the control group, the difference was Statistical significance(P<0.05). The accuracy of the two groups was 100% in the diagnosis of mesenteric vascular lesions by angiography and surgical outcome. Conclusion The dual source CT low dose scanning scheme has a high accuracy in the diagnosis of mesenteric ischemic disease and reduces the dose of radiation. It is of great value for popularization.

【关键词】双源CT;低剂量;血管造影; 肠系膜诊断;临床价值

【中图分类号】R572.3;R814.43;R814.42

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.02.013

前言

肠系膜缺血性疾病(Mesenteric Ischemia,MI)是临床中较为常 见的疾病,主要表现为肠道急性或慢性血流灌注不足、肠壁缺血坏 死、肠管运动功能障碍等一系列综合征。全身血液循环动力异常、疾 病引起的肠壁缺血、肠系膜血管病变等均会引发这一疾病[1]。随当代 生存年龄的增长、心血管疾病及自身免疫性疾病发病率增高的影响, 肠系膜出血性疾病的发病率也不断升高[2]。这一疾病临床特异性征象 较少,检出率低,所以具有较高的病死率。选择性肠系膜血管造影是 诊断这一疾病的金标准,但无法观察供血区肠管的情况,只能观察肠 系膜血管的堵塞及狭窄情况,且二维成像、前后组织重叠会造成一定 的失真[3-5],且其为有创检查、手术费用、并发症等增加了患者医疗成 本,难以推广应用。我院对2016年10月~2017年4月在我院就诊的100 例肠系膜缺血性疾病患者进行了双源CT低剂量诊断的临床研究,现将 成果报道如下。