本文選題：急腹癥 + 多層螺旋CT�。� 參考：《臨床放射學(xué)雜志》2017年09期

【摘要】：目的探討血管、腹膜及腸系膜源性急腹癥的MSCT表現(xiàn)特點(diǎn)及應(yīng)用價(jià)值。方法回顧性分析37例經(jīng)影像及臨床證實(shí)的血管、腹膜及腸系膜源性急腹癥MSCT平掃、增強(qiáng)及多種后處理技術(shù)成像資料。結(jié)果動脈瘤破裂并假性動脈瘤6例,發(fā)生在腹主動脈4例,腹腔干、左髂總動脈各1例;CT平掃表現(xiàn)為緊貼主動脈壁的軟組織腫塊影,增強(qiáng)后對比劑自主動脈腔溢出壁外進(jìn)入動脈瘤外的血腫包塊;腹主動脈夾層8例,CT增強(qiáng)7例見真假"雙腔",1例見腔內(nèi)新月形無強(qiáng)化的稍高密度影,提示壁內(nèi)血腫;血管栓塞16例,包括腸系膜上動、靜脈栓塞6例,腎動脈栓塞3例,脾動脈栓塞2例,門靜脈血栓形成5例,CT平掃2例表現(xiàn)為相應(yīng)動脈或靜脈內(nèi)稍高密度影,3例為等密度,增強(qiáng)掃描均呈血管腔內(nèi)充盈缺損;腸系膜扭轉(zhuǎn)3例,CT增強(qiáng)掃描示腸系膜及其血管呈"旋渦征"改變;腸系膜脂膜炎2例,腸系膜密度增高呈霧狀,周邊見"假包膜征",病變中可見"脂環(huán)征"及多發(fā)小結(jié)節(jié);原發(fā)性化膿性腹膜炎2例,表現(xiàn)為腹腔積液、積氣,網(wǎng)膜、腸系膜密度增高、水腫,腹膜多發(fā)膿腔形成。結(jié)論 MSCT增強(qiáng)及CTA重組是診斷血管源性急腹癥重要技術(shù);合適的窗寬、窗位可以增加腹膜、腸系膜源性急腹癥疾病診斷信息;腸系膜局部霧狀密度增高,其中多發(fā)小結(jié)節(jié)影及纖維條索狀密度增高影,邊緣有"假包膜征"和"脂環(huán)征"是診斷腸系膜脂膜炎依據(jù)。
[Abstract]:Objective to investigate the MSCT features and application value of vascular, peritoneal and mesenteric acute abdomen. Methods 37 cases of vascular, peritoneal and mesenteric acute abdomen confirmed by imaging and clinical data were retrospectively analyzed by MSCT plain scan, enhanced imaging and multiple post-processing techniques. Results 6 cases of ruptured aneurysm with pseudoaneurysm occurred in abdominal aorta in 4 cases, celiac trunk in 1 case and left common iliac artery in 1 case on CT plain scan. After contrast enhancement, contrast agents entered the hematoma mass outside the aneurysm from the overflow wall of the aortic cavity, 8 cases of abdominal aortic dissection were enhanced by CT in 7 cases, and 1 case of "double lumen" of true or false "double lumen" was seen, which indicated that the intracavitary hematoma was slightly higher than that of the crescent shape, which indicated that there was no enhancement in the intramural hematoma. Vascular embolization was performed in 16 cases, including superior mesenteric artery, vein embolization in 6 cases, renal artery embolization in 3 cases, splenic artery embolization in 2 cases, and portal vein thrombosis in 5 cases. Contrast enhanced scanning showed endovascular filling defect, mesenteric torsion in 3 cases, mesentery and its vessels as "vortex sign" in 3 cases, mesenteric panniculitis in 2 cases, mesenteric density increased in 2 cases. Peripheral "pseudocapsule sign", "lipid ring sign" and multiple small nodules were found in the lesion, and 2 cases of primary purulent peritonitis were characterized by peritoneal effusion, accumulation of air, omentum, mesentery density, edema, and multiple peritoneal cavity formation. Conclusion Enhancement of MSCT and recombination of CTA are important techniques in the diagnosis of vasogenic acute abdomen, suitable window width and window position can increase the diagnostic information of peritoneal and mesenteric acute abdomen disease, and the mesenteric local fog density is increased. Among them, multiple nodule shadow and fibrous stripe increased density shadow, the margin has "false capsule sign" and "lipid ring sign" are the basis for diagnosis of mesenteric panniculitis.
【作者單位】： 廣西北海市人民醫(yī)院放射科;
【分類號】：R656.1;R816.5

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 金銘;腸系膜動脈繼發(fā)多動脈血栓形成一例報(bào)告[J];中國病案;2005年01期

2 王用金;張劍梅;崔學(xué)會;;腸系膜動脈血栓8例診治分析[J];中國醫(yī)藥導(dǎo)刊;2010年02期

3 陳懷生;腸系膜血栓形成2例報(bào)告[J];中國實(shí)用內(nèi)科雜志;2001年10期

4 高玉軍,陳長明,李正斌,楊文益,趙偉;腸系膜上血栓形成16例分析[J];中國誤診學(xué)雜志;2003年09期

5 王建;紀(jì)震宇;吳文榮;;非閉塞性腸系膜動脈缺血一例[J];中華創(chuàng)傷雜志;2006年04期

6 鞏方明;劉洪俊;石玉龍;;急性腸系膜血管缺血性疾病18例臨床分析[J];中國現(xiàn)代普通外科進(jìn)展;2006年03期

7 吳性江;;腸系膜動脈缺血的診斷和治療[J];實(shí)用臨床醫(yī)藥雜志;2009年13期

8 李英,孫建民;急性腸系膜動脈缺血癥的治療[J];國外醫(yī)學(xué)(消化系疾病分冊);1983年01期

9 金旦年;;急性腸系膜 缺血的現(xiàn)代概念[J];國外醫(yī)學(xué).外科學(xué)分冊;1983年03期

10 馮變喜;王玉仙;侯一丁;賈守仁;傅信孚;;腸系膜動脈非阻塞性梗死(1例報(bào)道和文獻(xiàn)復(fù)習(xí))[J];天津醫(yī)藥;1984年08期

相關(guān)會議論文 前1條

1 王用金;;腸系膜動脈血栓8例診治分析摘要[A];中華醫(yī)學(xué)會急診醫(yī)學(xué)分會第十三次全國急診醫(yī)學(xué)學(xué)術(shù)年會大會論文集[C];2010年

相關(guān)碩士學(xué)位論文 前2條

1 吳建國;開放腸系膜淋巴管對小腸粘膜損傷修復(fù)及功能恢復(fù)影響的實(shí)驗(yàn)研究[D];中南大學(xué);2012年

2 白波;腸系膜淋巴引流在重癥急性胰腺炎并發(fā)急性肺損傷中的意義及清胰湯干預(yù)作用的實(shí)驗(yàn)研究[D];大連醫(yī)科大學(xué);2009年

，

本文編號：1826248