目的探討螺旋CT檢查在診斷表現(xiàn)為急性腹痛的狼瘡性缺血性腸?。╨upus ischemic bowel disease)中的價值。 方法回顧性分析23例因急性腹痛而行腹部螺旋CT掃描的系統(tǒng)性紅斑狼瘡(SLE)患者的臨床資料及CT圖像。23例中16例行增強CT掃描,7例行CT平掃。著重觀察腸道、腸系膜和腸系膜血管的異常CT表現(xiàn),同時也記錄其他腹部異常征象,如漿膜腔積液、實質(zhì)性臟器異常、淋巴結(jié)腫大等。 結(jié)果23例中19例(82.6%)出現(xiàn)腸壁腫脹、增厚,12例(75.0%)出現(xiàn)“靶征”,16例(69.6%)存在腸管擴張,21例(91.3%)出現(xiàn)腸系膜腫脹和脂肪密度增高,18例(78.3%)出現(xiàn)腸系膜血管充血、增粗,4例(25.0%)腸系膜血管呈“梳狀”排列。其它CT異常征象包括腹水、胸水、心包積液、肝、脾腫大、腎臟異常、腹膜后淋巴結(jié)腫大等。 結(jié)論出現(xiàn)急性腹痛的SLE患者行CT檢查時最常見為缺血性腸病的表現(xiàn)。螺旋CT增強掃描是診斷與鑒別診斷SLE所致缺血性腸病的最佳影像學(xué)方法。
引用本文: 宋彬,徐雋,羅小華,吳苾,程燕,張瑾. 螺旋CT檢查在診斷狼瘡性缺血性腸病中的價值. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(4): 359-363. doi: 復(fù)制
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- 4. 邢廣群,趙晨霄. 狼瘡性血管炎的臨床表現(xiàn)與發(fā)病機理 [J]. 中華腎臟病雜志, 1999; 15(4)∶25.
- 5. Kistin MG, Kaplan MM, Harrington JT. Diffuse ischemic colitis associated with systemic lupus erythematosus——response to subtotal colectomy [J]. Gastroenterology, 1978; 75(6)∶1147.
- 6. Hoffman BI, Katz WA. The gastrointestinal manifestations of systemic lupus erythematosus: a review of the literature [J]. Semin Arthritis Rheum, 1980; 9(4)∶237.
- 7. Laing TJ. Gastrointestinal vasculitis and pneumatosis intestinalis due to systemic lupus erythematosus: successful treatment with pulse intravenous cyclophosphamide [J]. Am J Med, 1988; 85(4)∶555.
- 8. Taourel PG, Deneuville M, Pradel JA, et al. Acute mesenteric ischemia: diagnosis with contrastenhanced CT [J]. Radiology, 1996; 199(3)∶632.
- 9. Heiberg E, Wolverson MK, Sundaram M, et al. Body computed tomography findings in systemic lupus erythematosus [J]. J Comput Tomogr, 1988; 12(1)∶68.
- 10. Ko SF, Lee TY, Cheng TT, et al. CT findings at lupus mesenteric vasculitis [J]. Acta Radiol, 1997; 38(1)∶115.
- 11. Reissman P, Weiss EG, Teoh TA, et al. Gangrenous ischemic colitis of the rectum: a rare complication of systemic lupus erythematosus [J]. Am J Gastroenterol, 1994; 89(12)∶2234.
- 12. Shapeero LG, Myers A, Oberkircher PE, et al. Acute reversible lupus vasculitis of the gastrointestinal tract [J]. Radiology, 1974; 112(3)∶569.