MSCT多平面及曲面重组技术在机械性肠梗阻诊断中的应用

目的:探讨MSCT多平面及曲面重组技术在机械性肠梗阻诊断中价值。方法:36例经手术、结肠镜病理证实或临床明确诊断的肠梗阻患者,行腹部MSCT平扫,扫描后进行回顾性0.6mm到1.0mm薄层重建,图像后处理技术包括MPR、CPR、MIP等,观察扩张积气的肠管、移行区和肠系膜,从而判断梗阻部位、梗阻原因及肠管血运状况。结果:粘连性肠梗阻21例,肠道肿瘤7例,炎症性肠梗阻5例,胆石性肠梗阻1例,肠扭转1例,腹外疝1例。正确诊断率为92.00%(32/36)。结论:横断位图像基础上增加MPR、CPR等MSCT图像重组技术,在明确肠梗阻病因、部位及性质等方面有重要临床价值,可以作为肠梗阻诊断的首选检查方法。

Application of MSCT with Multi-planar Reformation and Curve-planar Reformation Post-processing Techniques in the Diagnosis of Mechanical Small Bowel Obstruction

Objective:To assess the value of multi-slice spiral CT with multi-planar reformation and curve-planar reformation post-processing techniques in the diagnosis of mechanical small bowel obstruction.Methods:the entire abdominal MSCT was performed on 36 bowel obstruction patients,who had been made a definite diagnosis by operation,pathological confirmation through colonoscopy or clinical clear diagnosis.Retrospective thin-slice reconstruction 0.625 mm to 1.0 mm after multi-slice spiral CT scan,the techniques such as MPR,CPR and MIP,were used to observe the dilated bowel,transition zone,mesenterium in order to estimate the location,the cause of obstruction and the blood supply of the intestinal tube.Results:21 of the 36 cases were with adhesive intestinal obstruction and 7 of them were with intestinal tumor.The location and the causes of the 5 cases with inflammatory ileus were all clear diagnosed,1 case with gallstone ileus,1case with inguinal hernia and volvulus in 1 case were also determined.The rates of correct diagnosis were 92%.Conclusion:The different angle MPR and CPR of MSCT is added to transaxial images which could help to definite the cause,location,characteristics obstruction.MSCT examination and post-processing techniques are a preferred investigative method in confirming the locations and causes of the bowel obstruction in clinic.