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目的:探讨乙状结肠扭转(SV)的多层螺旋CT(MSCT)表现,以提高SV术前诊断水平。方法:回顾性分析手术病理或肠镜复位证实的15例乙状结肠扭转MSCT表现,归纳其影像学特征。结果:15例SV的MSCT征象有:15例均显示乙状结肠扩张,4例提示有肠管损害,包括肠壁增厚、肠系膜水肿、系膜间渗出和腹腔积液等;CT定位像显示倒“U”征14例,横断面图像显示“圆腹”征13例,“鸟嘴”征11例,MPR显示“交叉”征10例,“漩涡”征9例;CT增强及CTA显示肠壁强化减弱3例,肠系膜小血管闭塞1例,肠系膜动脉旋转2例。结论:乙状结肠扭转的MSCT表现具有一定特征性,尤其是肠管损害的判断对指导临床治疗有较大价值。
Objective: To investigate the multi-slice spiral CT (MSCT) of sigmoid colon torsion (SV) in order to improve the preoperative diagnosis of SV. Methods: Fifteen cases of sigmoid colon torsion MSCT confirmed by surgical pathology or colonoscopy were retrospectively analyzed, and their imaging features were summarized. Results: The MSCT signs of SV in 15 cases all showed sigmoid colon dilatation in 15 cases and bowel damage in 4 cases, including intestinal wall thickening, mesenteric edema, intermembrane exudation and ascites, “U ” sign in 14 cases, the cross-sectional image shows “round belly ” sign in 13 cases, “beak ” sign in 11 cases, MPR display “cross ” sign in 10 cases, " Cases; CT enhancement and CTA showed decreased intestinal wall enhancement in 3 cases, 1 case of mesenteric vascular occlusion, 2 cases of mesenteric artery rotation. Conclusion: The CT findings of sigmoid colon torsion have certain characteristics, especially the judgments of intestinal damage have great value in guiding the clinical treatment.