摘要
目的探讨老年人结肠穿孔常见疾病的MSCT影像表现。方法回顾性分析38例老年人结肠穿孔的MSCT资料。结果结肠穿孔CT主要表现:腹盆腔及腹膜后游离气体、肠腔外局限性小气泡,黏膜线中断、腹盆腔积液、脓肿形成。38例中,结肠癌15例,CT表现为肠壁不规则增厚,肠腔狭窄,系膜条索影。结肠Crohn病11例,CT表现为不对称性、节段性肠壁增厚,分层样强化,肠系膜血管增粗,小淋巴结。结肠憩室炎5例,CT表现为结肠肠壁外囊袋状突出,内见小气泡、粪石影。外伤性1例,医源性4例,不明原因2例。结论老年人易发生结肠穿孔,病因多样,CT表现有一定的特异性,有助于尽早诊断穿孔、明确穿孔病因,为临床及时制定手术方案提供依据。
Objective To evaluate the clinical value of CT in different diagnoses of colonic perforated disease in the old. Methods The MSCT data from 38 old patients confirmed for colonic perforated diseases by surgical pathology were retrospectively analyzed. Results Direct CT signs included pneumatosis in paracolic sulci and pelvis,limited extraluminal air,defect of ileocecal wall,thickening of adjacent wall,phlegmon,pelvic effusion. In 15 cases of colon cancer,CT showed irregular wall thickening,soft tissue density,heterogeneous enhancement and intestinal stenosis. In 11 cases of Crohn＇s disease,CT depicted segmental asymmetrical colonic wall thickening,layered enhancement,mesenteric vascular thickening,Comb＇s sign,and small mesenteric lymph nodes. In 5 cases of colonic diverticulosis,CT showed cavitated lesion with air-fluid level with intraperitoneal free air or fluid. 1 patient had traumatic perforation and Iatrogenic perforation was diagnosed in 4 cases. 2 cases unknown cause. Conclusion Colonic perforation is common in old patients,the causes are variable. The MSCT findings of those diseases are characteristic. These can improve the diagnostic accuracy and help in the clinical management.
出处
《临床放射学杂志》
CSCD
北大核心
2017年第7期1003-1006,共4页
Journal of Clinical Radiology
