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目的探讨肠系膜微小动脉瘤破裂伴肠腔内出血的CT表现。方法回顾性分析7例肠系膜微小动脉瘤破裂伴肠腔内出血患者64排螺旋CT的影像表现特点,采用动、静脉双期增强CT扫描及CTA重组对图像进行分析,重组方法采用容积再现(VR)、多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)等后处理技术。结果 7例患者动脉期增强扫描显示小肠肠管内小圆形高密度影,周围可见线样高密度影(4例位于空肠,2例位于回肠,1例位于结肠),静脉期高密度影范围增大、密度减低。5例显示病变区肠管管壁增厚,2例病变区肠管周围可见少量渗出性改变。7例患者CTA检查显示肠系膜微小动脉瘤存在(直径0.4~0.8 cm),其中1例显示多发微小动脉瘤。结论 MDCT双期增强扫描及CTA重组对肠系膜微小动脉瘤破裂合并肠腔内出血有极高的诊断价值,可以成为该病的首选检查方法。
Objective To investigate the CT manifestations of rupture of mesenteric aneurysm combined with intestinal lumen hemorrhage. Methods We retrospectively analyzed the imaging features of 64 cases of spiral CT with rupture of mesenteric aneurysm and intraluminal hemorrhage. The images were analyzed by dynamic and venous double-phase enhanced CT scan and CTA reconstitution. The volumetric reconstruction (VR) , MPR, CPR, MIP and other post-processing techniques. Results Seven patients underwent enhanced arterial phase scanning showed a small circular hyperdense in the small intestine, surrounded by linear high density (4 in the jejunum, 2 in the ileum and 1 in the colon) Large, reduced density. In 5 cases, intestinal wall thickening was found in the lesion area, and a small amount of exudative change was seen in the bowel of 2 cases. CTA examination of 7 patients showed the existence of mesenteric aneurysms (diameter 0.4 ~ 0.8 cm), of which 1 showed multiple aneurysms. Conclusions Dual-phase enhanced CT and CTA reconstruction of MDCT have a very high diagnostic value for the rupture of mesenteric aneurysm with intraluminal hemorrhage and may be the first choice for the diagnosis of this disease.