發(fā)布時(shí)間：2018-04-23 01:04

  本文選題：消化系統(tǒng)疾病 + 出血�。� 參考：《中國臨床醫(yī)學(xué)影像雜志》2016年02期

【摘要】：目的:探討大小腸雙充盈法腸道CT造影對不明原因消化道出血(OGIB)的診斷價(jià)值。方法:回顧性分析30例OGIB患者臨床資料,所有病例均作大小腸雙充盈法腸道CT造影檢查。結(jié)果:30例中惡性腫瘤5例,小腸間質(zhì)瘤4例,脂肪瘤1例,血管粗大畸形4例,毛細(xì)血管擴(kuò)張2例,炎性腸病5例,腸息肉3例,腸系膜上動脈血栓形成2例,腸系膜靜脈血栓形成1例,憩室2例,異位胰腺1例。10經(jīng)手術(shù)病理證實(shí),6例經(jīng)膠囊內(nèi)鏡證實(shí),4例血管病變經(jīng)DSA證實(shí),其余10例腸道CT造影診斷與臨床診斷相吻合。本組應(yīng)用大小腸雙充盈法腸道CT造影診斷準(zhǔn)確率為73.3%。遺漏的病變分別為血管畸形2例,毛細(xì)血管擴(kuò)張2例,小的息肉病變2例,小腸黏膜充血糜爛2例,遺漏原因?yàn)閿U(kuò)張的血管細(xì)小,小的息肉與腸黏膜難以區(qū)分,黏膜淺表性病變顯示不敏感。結(jié)論:大小腸雙充盈法腸道CT造影對OGIB的定位、定性診斷和指導(dǎo)臨床制定治療方案具有重要臨床價(jià)值,但易漏診淺表黏膜面病變及血管病變。
[Abstract]:Objective: to evaluate the diagnostic value of double-filling intestinal CT in patients with unknown gastrointestinal bleeding. Methods: the clinical data of 30 patients with OGIB were analyzed retrospectively. Results among 30 cases, 5 cases were malignant tumor, 4 cases were small intestinal stromal tumor, 1 case was lipoma, 4 cases were macrovascular malformation, 2 cases were capillary dilatation, 5 cases were inflammatory bowel disease, 3 cases were intestinal polyp, 2 cases were thrombosis of superior mesenteric artery. Mesenteric venous thrombosis in 1 case, diverticulum in 2 cases, ectopic pancreas in 1 case and ectopic pancreas in 1 case. 6 cases were confirmed by capsule endoscopy and 4 cases by DSA. The diagnostic accuracy of double filling small intestine CT was 73.3%. The missing lesions were vascular malformation (n = 2), capillary dilatation (n = 2), small polyp (n = 2), small intestinal mucosal congestion and erosion (n = 2). Superficial mucosal lesions were insensitive. Conclusion: double filling small intestine CT angiography has important clinical value in the localization, qualitative diagnosis and guidance of clinical treatment for OGIB, but it is easy to miss the diagnosis of superficial mucosal lesions and vascular lesions.
【作者單位】： 江蘇省揚(yáng)中市人民醫(yī)院影像科;
【分類號】：R57;R816.5

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