Abstract：Objective: To investigate the value of CT in differentiating small bowel ischemia from infarction in patients with adhesive small bowel obstruction(ASBO). Methods: According to operative results, thirty-seven patients with ASBO were classified into ischemia group and infarction group. The CT findings of two groups were retrospectively compared and analyzed. Results: The incidence of bowel wall pneumatosis, mesenteric haziness, decreased enhancement of bowel wall, decreased enhancement of mesenteric arteries and veins of on CT imaging in the infarction group was statistically higher than that in the ischemia group, with odds ratio for infarction of 3.78, 11.91, 10.15, 16.50, and 19.55, respectively. The positive predictive value of a combination of 4 or more CT findings for small bowel infarction was 83.3%(10/12). Conclusion: CT imaging finding is helpful in differentiating small bowel ischemia from infarction in patients with ASBO, and decreased enhancement of mesenteric veins is the most valuable CT findings.
王玉强，庞闽厦，刘 磊. CT鉴别粘连性小肠梗阻所致肠缺血和梗死的价值[J]. 中国临床医学影像杂志, 2017, 28(8): 568-570.
WANG Yu-qiang, PANG Min-xia, LIU Lei. Value of CT in differentiating small bowel ischemia from infarction in patients with adhesive small bowel obstruction. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(8): 568-570.
[1]Millet I, Taourel P, Ruyer A, et al. Value of CT findings to predict surgical ischemia in small bowel obstruction: A systematic review and meta-analysis[J]. Eur Radiol, 2015, 25(6): 1823-1835.
[2]Dhatt HS, Behr SC, Miracle A, et al. Radiological evaluation of bowel ischemia[J]. Radiol Clin North Am, 2015, 53(6): 1241-1254.
[3]刘磊，庞闽厦，王玉强，等. 肠系膜血管CTA在小肠梗阻治疗中的应用价值[J]. 实用放射学杂志，2015，31（2）：255-257.
[4]刘磊，庞闽厦，苏伟，等. 小肠梗阻所致小肠梗死的肠系膜血管CTA表现[J]. 中国临床医学影像杂志，2014，25（9）：669-671.
[5]王海波，刘白鹭，刘新顶，等. CT平扫对肠坏死诊断价值[J]. 现代生物医学进展，2015，15（22）：4291-4294.
[6]Lee SS, Ha HK, Park SH, et al. Usefulness of computed tomography in differentiating transmural infarction from nontransmural ischemia of the small intestine in patients with acute mesenteric venous thrombosis[J]. J Comput Assist Tomogr, 2008, 32(5): 730-737.
[7]Makita O, Ikushima I, Matsumoto N, et al. CT differentiation between necrotic and nonnecrotic small bowel in closed loop and strangulating obstruction[J]. Abdom Imaging, 1999, 24(2): 120-124.
[8]Wiesner W, Mortele K. Small bowel ischemia caused by strangulation in complicated small bowel obstruction. CT findings in 20 cases with histopathological correlation[J]. JBR-BTR, 2011, 94(6): 309-314.
[9]Nakashima K, Ishimaru H, Fujimoto T, et al. Diagnostic performance of CT findings for bowel ischemia and necrosis in closed-loop small-bowel obstruction[J]. Abdom Imaging, 2015, 40(5): 1097-1103.
[10]Bani Hani M, Kamangar F, Goldberg S, et al. Pneumatosis and portal venous gas: do CT findings reassure?[J]. J Surg Res, 2013, 185(2): 581-586.
