摘要
目的探讨多层螺旋CT (MSCT)增强扫描诊断隐匿性消化道出血中胃肠道血管畸形(GIVM)的价值。方法随机选取2013年3月至2016年3月我院收治的GIVM患者50例,均行MSCT增强扫描检查,并与经数字减影血管造影(DSA)检查、手术结果进行比较。结果 50例患者经MSCT增强扫描确诊为GIVM。MSCT平扫没有异常,动脉期血管成像分别在MPR、 MIP及VR影像显示迂曲条状或结节状明显强化病变29例(58.0%),不规则异常血管团21例(42.0%), 13例表现为邻近肠腔内对比剂聚集,同时会随时间推移而增多。供血动脉31例,引流静脉18例,其中动静脉瘘9例。50例GIVM中40例行MSCT检查后5天进行DSA和动脉栓塞治疗, MSCT血管成像和DSA对GIVM的定性诊断及病变定位诊断均完全一致(100.0%),40例胃肠道血管畸形供血动脉和引流静脉、动静脉瘘的显示率分别为77.5%、 45.0%和90.0%,组间对比差异有统计学意义(P <0.05)。5例经过手术治疗得到证实, 5例行保守治疗后出血情况得到治愈,但是没有获得明确的诊断结果。结论 MSCT检查能够清楚、准确地显示出GIVM的部位、范围、形态和影像特征,可作为由GIVM造成的隐匿性消化道出血的常规检查手段。
Objective To explore the value of multi-slice spiral CT (MSCT)enhanced scan in the diagnosis of gastrointestinal vascular malformation (GVM)in patients with occult gastrointestinal hemorrhage.Methods 50cases of patients with GIVM in our hospital from March 2013to March 201.6were randomly selected.All cases underwent MSCT enhanced scan,and the results were compared with DSA and operation results.Results 50patients were diagnosed as GIVM by MSCT enhanced scarL MSCT plain scan showed no abnormalities. Arterial angiography showed tortuous strip or nodular enhancement lesions in 29cases (58.0%),irregular abnormal vascular duster in 21 cases (42.0%),with MIP and MPR VR imaging respectively.13cases showed a concentration of contrast agents in the adjacent lumen and increased over time.The examination showed 31cases of blood supply artery,18cases of venous drainage,including 9cases of arteriovenous fistula.5days after MSCT inspection,40GIVM cases received DSA examination and embolization therapy,whose MSCT angiography diagnosis and DSA diagnosis of GIVM were exactly the same (100.0%).The display rates of blood supply arteries,draining veins and arteriovenous fistulas in 40cases of GIVM were 77.5%,45.0%and 90.0%,with statistically significant difference between the groups (P <0.05).5patients were confirmed after surgical treatment,and 5patients with uncertain diagnosis recovered after conservative treatment. Conclusions MSCT scan can clearly and accurately show the location,scope,shape and image features of GIVM,which can be used as a routine examination method for GIVM in patients with occult gastrointestinal hemorrhage.
作者
施武
吴少杰
陈渊明
许燕塔
SHI Wu;WU Shaojie;CHEN Yuanming;XU Yanta(Department of Radiology,the First Affiliated Hospital of Xiamen University,Xiamen 361022,China)
出处
《临床医学工程》
2018年第12期1591-1592,共2页
Clinical Medicine & Engineering
