摘要
目的 探讨螺旋CT检查在诊断表现为急性腹痛的狼疮性缺血性肠病 (lupusischemicboweldisease)中的价值。方法 回顾性分析 2 3例因急性腹痛而行腹部螺旋CT扫描的系统性红斑狼疮 (SLE)患者的临床资料及CT图像。 2 3例中 16例行增强CT扫描 ,7例行CT平扫。着重观察肠道、肠系膜和肠系膜血管的异常CT表现 ,同时也记录其他腹部异常征象 ,如浆膜腔积液、实质性脏器异常、淋巴结肿大等。结果 2 3例中 19例 ( 82 .6 % )出现肠壁肿胀、增厚 ,12例 ( 75 .0 % )出现“靶征” ,16例 ( 6 9.6 % )存在肠管扩张 ,2 1例 ( 91.3% )出现肠系膜肿胀和脂肪密度增高 ,18例 ( 78.3% )出现肠系膜血管充血、增粗 ,4例 ( 2 5 .0 % )肠系膜血管呈“梳状”排列。其它CT异常征象包括腹水、胸水、心包积液、肝、脾肿大、肾脏异常、腹膜后淋巴结肿大等。结论 出现急性腹痛的SLE患者行CT检查时最常见为缺血性肠病的表现。螺旋CT增强扫描是诊断与鉴别诊断SLE所致缺血性肠病的最佳影像学方法。
Objective To evaluate the value of spiral CT in diagnosing ischemic bowel changes in systemic lupus erythematosus (SLE) patients presenting with acute abdominal pain. Methods The clinical data and spiral CT imaging files of 23 SLE patients presenting with acute abdominal pain were retrospectively reviewed. Sixteen had contrast enhanced spiral CT scanning of the abdomen, the rest had plain CT study. Observation emphasis was placed on the changes of bowel wall (wall thickness, enhancement pattern, lumen size) and mesentery (mesenteric edema, engorgement of mesenteric vessels and their abnormal arrangement pattern). Other abnormal findings (e.g. fluid accumulation, changes of abdominal solid organs, lymphadenopathy) were also observed. Results Nineteen patients had intestinal wall thickening (19/23, 82.6%), with the 'target sign' in 12 patients (12/16, 75.0%); Bowel lumen dilatation was present in 16 patients (16/23, 69.6%). Mesenteric swelling with increased density of adipose tissue was noticed in 21 patients (21/23, 91.3%); 18 patients had engorgement of mesenteric vessels (18/23, 78.3%), with comb like arrangement in 4 patients (4/16, 25.0%). Other abnormal findings included ascites, hydrothorax, hydropericardium, hepatosplenomegaly and so on. Conclusion The most common CT findings in SLE patients presenting with acute abdominal pain are the signs associated with ischemic bowel disease. Contrast enhanced spiral CT is a preferable imaging method for both the diagnosis and differential diagnosis of ischemic bowel disease associated with SLE.
出处
《中国普外基础与临床杂志》
CAS
2004年第4期359-363,共5页
Chinese Journal of Bases and Clinics In General Surgery
