论文部分内容阅读
Objective.The purpose of this study was to retrospectively evaluate the diagnostic performance of intestinal malrotation in children on computed tomography (CT) images.MATERIALS AND METHODS.We retrospectively reviewed 19 cases of intestinal malrotation in 13 boys and 6 girls.All of these patients had been preoperatively diagnosed by CT as having malrotation.At the same time,a prospective determination was made based on the CT studies as to whether there was any associated intestinal malrotation.Three radiologists evaluated CT images for several specific imaging signs of intestinal malrotation.A general impression was assigned to CT images.CT findings suggesting bowel compromise were compared with operative findings.RESULTS.The most specific signs of CT findings as follow: (1)duodenum assumed as “Z-shape”configuration or “beak sign”,duodenojejunal junction(DDJ) lay to the right of vertebral column(17 of 19 cases,89%).(2) absence of cecum in the right lower quadrant (18 of 19 cases,95%).(3) abnormal relationship between the superior mesenteric artery(SMA) and superior mesenteric vein(SMV)(14 of 19 cases,74%).(4) whirl sign in the root of mesentery while accompany with midgut volvulus( 10 of 19 cases,53%).(5) abnormal position or whirl sign of other mesenteric vessels( 4 of 19 cases,21%).CONCLUSION.Diagnosis of intestinal malrotation in children with CT remains difficult.When intestinal malrotation is suspected,abnormal position of DDJ or cecum,abnormal relationship between the SMA and SMV,whirl sign in the root of mesentery have high specificity for intestinal malrotation.