摘要
目的分析急性肠系膜上动脉栓塞(ASMAE)患者的血管基础病变CT影像,为及早筛查易患人群提供依据。方法回顾性分析解放军总医院2008年1月-2013年12月确诊ASMAE并有腹部增强CT及在发病2年内曾在本院做过腹部CT平扫检查患者的CT资料。随机抽取同期住院并行腹部CT平扫+增强检查的40例非缺血性肠病患者作为对照。借鉴冠脉钙化积分方法评估肠系膜上动脉(SMA)及其开口上下各3 cm段腹主动脉钙化积分,借助Volume软件测定非钙化体积,从钙化及非钙化角度了解ASMAE的肠道动脉血管基础病变。结果病例组目标段腹主动脉总平均钙化积分高于对照组,差异无统计学意义(P=0.361)。病例组以块状钙化和环周钙化为主,而对照组以点状或条形钙化为主,病例组更严重的钙化程度与对照组比较,差异有统计学意义(P<0.001)。病例组钙化斑块分布于SMA开口水平以上者、目标段腹主动脉非钙化体积均高于对照组(P=0.046、0.031),SMA开口部直径小于对照组(P<0.001)。结论腹主动脉更严重的环周型及块状钙化、位于SMA开口水平以上的钙化斑块、更大的非钙化负荷及SMA开口部位非钙化病变导致的管腔狭窄是ASMAE的血管基础病变,临床医师应加以重视。
Objective To elucidate the basic vasculopathy of acute superior mesenteric artery embolism （ASMAE） in CT imaging. Methods CT data of 40 ASMAE patients and 40 non ischemic bowel disease （ICBD） patients from Jan. 2008 to Dec. 2013 in the PLA General Hospital were retrospectively analyzed. The Agatston calcium scores were used to evaluate calcium scores of superior mesenteric artery （SMA） and adjacent 6 cm abdominal aorta. The intimately shapes and distribution characteristics of calcification plaque were described. The volume software was used to calculate volume of non-calcification plaque, and intestinal artery atheroselerosis course was understood through calcification plaque and non-calcification plaque. Results No difference was found in the total mean calcium score of examined ab- dominal aorta between the ASMAE patients and the non-[CBD controls （P = 0. 361 ）. Predominant mass calcification and circle calcification were found in ASMAE patients with severe calcification （P 〈0. 001 ）. Whereas dot calcification and stripe calcification were found in the non-ICBD controls. The ASMAE patients had more calcification plaque locating at proximal to SMA （P = 0. 046） , larger non-calcium volume of examined abdominal aorta （ P = 0.031 ） , and smaller orifice diameters of SMA （P 〈 0. 001 ）. Conclusion Mass calcification, circle calcification of abdominal aorta, calcifi- cation plaque locating at proximal to SMA, large non-calcium volume in a specific abdominal aorta and orifice stenosis of SMA caused by non-calcium lesions may be basic vasculopathy of ASMAE, which should be paid more attention by clin- ical physician.
出处
《胃肠病学和肝病学杂志》
CAS
2015年第5期586-589,共4页
Chinese Journal of Gastroenterology and Hepatology
基金
解放军总医院临床科研扶持基金(2013FC-TSYS-1004)
军队保健专项科研课题(12BJZ31)
关键词
急性肠系膜上动脉栓塞
腹主动脉
钙化
CT影像
Acute superior mesenteric artery embolism
Abdominal aorta
Calcification
CT imaging
