关于小肠结石嵌顿的MSCT诊断分析

胡国辉

中国临床医学影像杂志 ›› 2015, Vol. 26 ›› Issue (9) : 650-652.

论著

关于小肠结石嵌顿的MSCT诊断分析

胡国辉

作者信息 +

MSCT diagnostic analysis on small intestinal calculus incarcerated

HU Guo-hui

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文章历史 +

摘要

目的：探讨小肠结石的MSCT诊断价值。方法：回顾性分析与总结5例经手术病理证实的小肠结石的临床特征及CT表现。结果：本组5例中，2例结石梗阻发生于空肠，由胆囊结石所致；3例结石嵌顿于回肠，其中2例由胃柿石所致，1例为十二指肠憩室内结石下移所致。均表现为肠腔内椭圆形结节影，密度高低不等，边界清晰，无强化，肠道造影可见肠腔内椭圆形充盈缺损，可见“杯口”征，“分流”征，随诊检查，可见“游走”征。结论：小肠结石的影像表现具有一定的特征性，相对于常规腹部平片、超声、钡餐造影等检查，MSCT对此具有明显的诊断优势，经过图像后处理技术，对小肠内结石特点及周围解剖关系显示清晰，有助于病变的定性、定位诊断。

Abstract

Objective: To study the value of MSCT in the diagnosis of small intestinal calculi. Methods: The clinical features and CT findings of 5 cases of small stones confirmed by surgery pathology were retrospectively analyzed and summarized. Results: In the 5 cases, 2 cases of calculus obstruction occurred in jejunum, which are caused by gallbladder stones; 3 cases of calculus incarcerated in the ileum, among which two cases are caused by gastric stone down, one case of duodenal diverticulum stones down inside. They are characterized by oval nodes within the lumen, density of high and low range, the boundary clear, no reinforcement, visible lumen inside the oval filling defect, visible “rim”, “tap” sign, follow-up inspections, visible “walk” sign. Conclusion: Small stone image performance has a certain characteristic. Compared with the conventional abdominal plain film, ultrasound and barium meal examination, MSCT has obvious diagnostic advantage. Through the image post-processing technology, characteristics of stones in the intestine and the surrounding anatomic relationship can be showed clearly. MSCT may be a useful tool in the qualitative, positioning diagnosis of lesions.