成人肠套叠的CT影像特征及其临床应用价值

目的：探讨成人肠套叠的CT影像特征及其临床应用价值。方法：回顾性分析经手术证实的42例成人肠套叠患者的CT和临床资料。结果：42例成人肠套叠CT均见肿块样改变,其中＂靶征＂27例（64%）例,＂肾形征＂18例（43%）,＂彗星尾征＂15例（36%）,＂腊肠征＂11例（26%）,＂双肠管征＂8例（19%）,＂胎儿征＂3例（7%）,近端肠管扩张30例（71%）,肠梗阻15例（36%）,肠壁增厚12例（29%）。42例肠套叠均为继发性,共42处原发病变,其中脂肪瘤、息肉各8例（19%）,腺癌6例（15%）,恶性淋巴瘤、梅克尔憩室各3例（7%）,间质瘤、血管瘤、神经纤维瘤、盲肠游离症、术后粘连各2例（5%）,粘液腺癌、恶性间皮瘤、错构瘤、胰腺导管异位各1例（2%）。套叠部位：小肠型肠套叠17例（41%）,回盲部型10例（24%）,回-结肠型9例（21%）,结肠型6例（14%）。结论：成人肠套叠的CT表现具有特征性,对其诊断、原发病的确定和手术治疗均具有重要的参考价值。

Characteristics of CT Imaging in the Adult Intussusception and Its Clinical Application Value

Objective： To discuss the CT features and pathological basis of adult intussusception.Methods： CT features and clinical data of 42 cases with surgically proven adult intussusception were retrospectively analyzed.Results： Mass-like lesions were found in all the 42 cases,including target signs in 27 cases（64%）,kidney-shaped signs in 18 cases（43%）,comet-tail signs in 15 cases（36%）,sausage signs in 11 cases（26%）,bowel-within-bowel signs 8 in cases（19%）,fetus signs in 3 cases（7%）,dilation of proximal intestinal in 30 cases（71%）,intestinal obstruction in 15 cases（36%）,and bowel wall thickness in 12 cases（29%）.42 cases with 42 primary lesions were reported.All cases were secondary to primary lesions including lipoma in 8 cases（19%）,polyp in 8 cases（19%）,adenocarcinoma 6 in cases（15%）,malignant lymphoma in 3 cases（7%）,Meckel＇s diverticulum in 3 cases（7%）,Gastrointestinal Stromal Tumors in 2 cases（5%）,angioma in 2 cases（5%）,neurofibroma in 2 cases（5%）,Mobile Cecum Syndrome 2 in cases（5%）,postoperative adhesions in 2 cases（5%）,mucinous adenocarcinoma in 1 case（2%）,malignant mesothelioma in 1 case（2%）,hamartoma in 1 case（2%）,and ectopic pancreatic tissue in 1 case（2%）.The types of intussusception were as follows： enteroenteric intussusception in 17 cases（41%）,ileocecal type in 10 cases（24%）,ileocolonic type in 9 cases（21%）,and colocolonic type in 6 cases（14%）.Conclusion： The CT findings were characteristic in the patients with adult intussusception,which had an important role in the diagnosis,determination of primary disease and surgical treatment of adult intussusception.