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目的总结小肠扭转(SBV)的CT和CT血管成像(CTA)表现,探讨CTA对其诊断价值。资料与方法回顾性分析8例经手术证实的SBV的CT与CTA表现。所有患者均行CT平扫+双期增强扫描(动脉期和门静脉期),并进行CT血管重组。阅片医师依靠CTA来判断SBV的部位、扭转的方向和度数,并与手术结果对照。结果8例SBV的CT征象包括肠系膜血管“漩涡征”6例,肠管“漩涡征”5例,肠管“靶环征”和“鸟喙征”各3例,肠管壁强化减弱、肠壁水肿4例,腹腔积液1例。CTA表现:5例肠系膜上动脉(SMA)主干位置、形态正常,1例SMA主干近端扭转,1例SMA分支扭转,1例出现SMA与肠系膜上静脉(SMV)相互缠绕,4例见SMV主干的轴向扭转并扩张,3例表现为SMV的分支的扭转及走行异常,4例显示走行异常的SMV属支增粗。依靠CTA,8例均能正确判断SBV的位置、扭转的方向。5例正确判断SBV度数,3例CTA计算的度数较手术发现的小。结论CTA对SBV的诊断有重要的价值,能准确判断SBV的方向和部位,但对扭转度数的判断有一定的限度。
Objective To summarize CT and CT angiography (CTA) findings of small intestine torsion (SBV) and investigate the diagnostic value of CTA. Materials and Methods Retrospective analysis of 8 cases of surgically confirmed SBV CT and CTA findings. All patients underwent CT scan + double-phase enhanced scan (arterial phase and portal vein phase), and CT vascular reconstruction. Reading physicians rely on CTA to determine the location of SBV, the direction and degree of torsion, and the results of surgery. Results CT signs of 8 cases of SBV included 6 cases of mesenteric vessels, 5 cases of intestinal vessels, 5 cases of intestinal vessels, 3 cases of intestinal vessels and 3 cases of bird beaks, Wall weakening, intestinal wall edema in 4 cases, 1 case of abdominal effusion. CTA showed that the main site of the superior mesenteric artery (SMA) was located in 5 cases. The shape of the trunk was normal. One of the SMA torsion proximally and the SMA branch reversed one case. SMA and SMV were entangled in one case and the SMV trunk in 4 cases Of the axial torsion and expansion, 3 cases showed the branch of SMV torsion and abnormal walking, 4 cases of walking abnormal SMV is thick branches. Relying on CTA, 8 cases can correctly determine the location of SBV, reverse the direction. Five cases correctly judged the SBV degree, 3 cases of CTA calculated less than the surgical findings. Conclusion CTA has an important value in the diagnosis of SBV. It can accurately determine the direction and location of SBV, but there is a certain limit to the judgment of the degree of torsion.