本文選題：紫癜 + 過敏性　； 參考：《中國(guó)醫(yī)學(xué)影像學(xué)雜志》2015年05期

【摘要】：目的分析腹型過敏性紫癜(AAP)的多層螺旋CT(MSCT)表現(xiàn),探討MSCT檢查在AAP療效評(píng)價(jià)中的作用。資料與方法回顧性分析13例經(jīng)臨床和實(shí)驗(yàn)室檢查確診為AAP患者的臨床和CT檢查資料,治療前均行腹部CT平掃及薄層重建,8例行胃鏡檢查;治療后10例行CT平掃復(fù)查,4例行胃鏡復(fù)查。比較治療前后臨床表現(xiàn)和CT征象的差異。結(jié)果治療前13例CT平掃中,2例一段腸管受累,10例多節(jié)段腸管受累,1例無陽(yáng)性發(fā)現(xiàn);8例累及十二指腸、空回腸,5例累及胃;受累腸管壁環(huán)形增厚,密度減低,腸腔均勻性狹窄,輪廓模糊不清,呈"雙環(huán)"征;10例腸管周圍見少量滲出,3例腹腔少量積液。CT平掃誤診為急性胰腺炎2例,急性膽囊炎、腸梗阻、腹膜炎各1例。13例患者中,治愈5例,有效8例�；颊咧委熀笏闹ふ睢⒏雇�、大便潛血、白細(xì)胞升高、嘔吐、黑便、尿潛血癥狀較治療前均得到改善(χ2=5.59~18.33,P0.05、P0.01);10例CT復(fù)查多節(jié)段腸管水腫、腸管周圍滲出改變均顯著改善(χ2=10.00、9.52,P0.01),腹腔積液差異無統(tǒng)計(jì)學(xué)意義(χ2=1.14,P0.05)。結(jié)論 AAP的CT表現(xiàn)無特異性,皮疹出現(xiàn)前MSCT診斷困難,結(jié)合多節(jié)段腸管水腫、滲出等基本CT征象和臨床表現(xiàn)有利于本病的診斷,MSCT檢查可以有效評(píng)價(jià)AAP的治療效果。
[Abstract]:Objective to analyze the MSCT findings of abdominal anaphylactoid purpura (AAP) and to explore the role of MSCT in evaluating the efficacy of AAP. Materials and methods the clinical and CT findings of 13 patients with AAP confirmed by clinical and laboratory examinations were retrospectively analyzed. All patients underwent plain abdominal CT scan and 8 cases of gastroscopy before treatment. After treatment, 10 cases underwent CT plain scan and 4 cases underwent gastroscopy. To compare the difference of clinical manifestations and CT signs before and after treatment. Results before treatment, 13 cases of CT plain scan in 2 cases with one segment of intestinal canal involvement, 10 cases with multiple segment intestinal involvement, 1 case without positive findings, 8 cases involving duodenum, 5 cases of jejunum and ileum involvement of stomach, the wall of the involved intestine was thickened, the density was decreased, and the intestinal lumen was homogeneously narrow, the wall of the involved intestine was thickened, the density was decreased, and the intestinal cavity was homogeneously narrow. In 10 cases with "double ring" sign, 3 cases were misdiagnosed as acute pancreatitis, 1 case with acute cholecystitis, 1 case with intestinal obstruction and 1 case with peritonitis, 5 cases were cured, 3 cases were misdiagnosed as acute pancreatitis, 1 case of acute cholecystitis, 1 case of intestinal obstruction and 1 case of peritonitis. Effective 8 cases. The symptoms of extremities rash, abdominal pain, stool occult blood, leukocytosis, vomiting, black stool and urine occult blood were all improved after treatment (蠂 ~ 2 5.59 ~ 18.33% P 0.05 P 0.05 P 0.01). The changes of peri-intestinal exudation were significantly improved (蠂 ~ 2 / 10.00 / 9.52 / P _ (0.01), but there was no significant difference in peritoneal effusion (蠂 ~ (2) = 1.14 / P ~ (0.05). Conclusion CT findings of AAP are not specific, MSCT is difficult to diagnose before the appearance of skin rash. Combined with basic CT signs and clinical manifestations, such as multilevel intestinal edema and exudation, can effectively evaluate the therapeutic effect of AAP.
【作者單位】： 武漢市中心醫(yī)院核醫(yī)學(xué)科;武漢科技大學(xué)附屬天佑醫(yī)院;武漢市第一醫(yī)院放射科;
【分類號(hào)】：R554.6;R816.3

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