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目的:分析老年性缺血性肠炎的影像学表现,探讨老年性缺血性肠炎的影像学诊断价值。方法:对照综合分析本院近年来经临床、手术病理证实的9例老年性缺血性肠炎的X线、CT和DSA的影像资料和病理结果。结果:9例老年性缺血性肠炎者X线立位、卧位摄片,均见腹部肠腔扩张,积气、积液,8例CT均显示肠腔广泛扩张,积气、积液,并见节段性肠壁增厚、粘膜下水肿呈靶征,4例可见大量腹水。4例行肠系膜动脉CTA多平面重组(MPR),显示局部肠系膜动脉分支狭窄变细;2例行DSA示肠系膜上、下动脉纤细、远端分支显示不清。5例行手术治疗,术中见局部肠管呈暗红或暗黑色,粘膜广泛糜烂、坏死。组织病理片示肠系膜小动脉内膜纤维性增厚,血管壁间质纤维化;4例经保守支持治疗,2周后症状缓解出院。结论:对老年人不明原因的肠梗阻要考虑肠系膜血管缺血的可能,应及时作CT检查以明确诊断。
Objective: To analyze the imaging findings of senile ischemic enteritis and explore the diagnostic value of senile ischemic enteritis. Methods: The imaging data and pathological findings of X-ray, CT and DSA in 9 cases of senile ischemic enteritis confirmed by clinical and surgical pathology in our hospital in recent years were analyzed. Results: In 9 cases of senile ischemic enteritis, X-ray position and supine position were observed. All of the abdominal cavity expansion, gas accumulation and fluid accumulation in the abdomen were observed. CT in 8 cases showed wide expansion of intestine cavity, See segmental intestinal thickening, submucosal edema was a target, 4 cases showed a lot of ascites. 4 cases of mesenteric artery CTA multiplanar reconstruction (MPR), showing narrowing of the local mesenteric artery stenosis; 2 cases of DSA showed superior mesenteric artery stenosis, distal branch showed unclear. 5 cases of surgical treatment, intraoperative see partial bowel dark red or dark, mucosal erosion, necrosis. Histopathological examination showed that the mesenteric arterioles intima had fibrous fibrosis and vascular wall interstitial fibrosis. Four patients were treated with conservative support and were relieved after 2 weeks. Conclusion: It is necessary to consider the possibility of ischemia of mesenteric vessels for unknown obstruction in the elderly. CT examination should be done in time to confirm the diagnosis.