多层螺旋CT及图像后处理在肠梗阻诊断中的应用价值

Value of multi-slice CT and post-processing techniques in the diagnosis of bowel obstruction

关键词:  肠梗阻  体层摄影  图像处理

Key words:  bowel obstruction  tomography  image processing

摘要:

［目的］探讨多层螺旋CT及图像后处理在肠梗阻诊断中的应用价值。［方法］16例经手术、结肠镜病理证实或临床明确诊断的肠梗阻患者，行全腹部MSCT平扫及三期增强扫描，图像薄建后工作站进行图像后处理，采用MIP、MPR、CPR、VRT、VE等技术，观察扩张积气的肠管、移行区、肠系膜上动脉、静脉，从而判断梗阻部位、梗阻原因及肠管血运状况。［结果］16例患者诊断明确，其中：机械性肠梗阻12例，血运性肠梗阻4例。12例机械性肠梗阻均明确诊断梗阻部位及梗阻原因，4例血运性肠梗阻明确病变的血管及累及的肠管。完全性肠梗阻9例，不完全肠梗阻7例。［结论］MSCT对肠梗阻的诊断在横断位图像上增加多方位图像重组，可以明确诊断肠梗阻病因、部位、梗阻性质，可以作为临床诊断的首选检查方法。

Abstract:

［Objective］To assess the value of Multi-slice CT and post-processing techniques in the diagnosis of bowel obstruction.［Methods］The entire abdominal MSCT and three phases strengthen scanning were performed on 16 bowel obstruction patients,who had been made a definite diagnosis by operation,pathological confirmation through colonoscope or clinical clear diagnosis.The images were reconstructed.The techniques,such as MIP,MPR,CPR,VRT and VE,were used to observe the dilated bowel,transition zone,superior mesenteric artery and vein in order to estimate the location,the cause of the obstruction,and the blood supply of the intestinal tube.［Results］Twelve of the 16 cases were with mechanical intestinal obstruction and 4 of them were with vascular intestinal obstruction.The location and the causes of the 12 cases with mechanical obstruction were all clear diagnosed,and the vessels and the involved intestinal tube of 4 cases with vascular intestinal obstruction were also determined.Nine cases of the 16 patients were complete obstruction,and other 7 cases were partial obstruction.［Conclusion］The different angle MPR of MSCT is added to transaxial images which could help to definite the cause,location,characteristics of bowel obstruction.The MSCT is a preferred investigative method to definitely diagnose the bowel obstruction in clinic.