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Các dấu hiệu chụp cắt lớp vi tính chẩn đoán thiếu máu và hoại tử ruột ở tắc ruột non quai kín

Mục tiêu của nghiên cứu này là để tìm các dấu hiệu hình ảnh trên CCLVT có tiêm tương phản để chẩn đoán thiếu máu và/hay hoại tử ruột ở tắc ruột non quai kín nhằm dự đoán sự cần thiết của cắt bỏ ruột hay bảo tồn. | NGHIÊN CỨU KHOA HỌC CÁC DẤU HIỆU CHỤP CẮT LỚP VI TÍNH NGHIÊN CỨU KHOA HỌC CHẨN ĐOÁN THIẾU MÁU VÀ HOẠI TỬ SCIENTIFIC RESEARCH RUỘT Ở TẮC RUỘT NON QUAI KÍN CT findings for diagnosis of bowel ischemia and necrosis in closed-loop small-bowel obstruction Vũ Thị Thu Hương Võ Tấn Đức SUMMARY Purpose The aim of this study was to investigate the imaging features of contrast-enhanced CT CECT to diagnosis for bowel ischemiaand necrosis in closed-loop small-bowel obstruction CL-SBO and to predict the need for intestinal resection or preservation. Materials and Methods Thirty-three patients with CL-SBO confirmed by laparotomy. Based on the surgical findings these patients were classified into three groups necrosis group n 9 ischemia without necrosis group n 12 and no-ischemia group n 12 . Two blinded radiologists retrospectively reviewed CECT including multiplanar reconstruction images and evaluated 11 CT findings. The sensitivity and specificity of each finding were compared among the three groups and logistic regression analysis was performed. Results Reduced bowel- wall enhancement reduced enhancement of the mesenteric veins showed high specificities of 92 96 and sensitivities of 62 and 78 respectively for the prediction of bowel necrosis in CL-SBO. The target sign in the ischemia group were 83 and 76 respectively for sensitivities and specificities compared with 22 and 46 of the necrosis group. We have included the data in a univariate and multivariate logistic regression analysis but there is no correlation between imaging features and surgical findings. This can be explained by the interval between CT and laparotomy has altered bowel conditions. Conclusions In our prospective patients reduced enhancements of bowel wall and mesenteric veins were good indicators of bowel necrosis. On the contrary target sign was a predictor of a viable bowel. Key words intestinal obstruction closed loop ischemia necrosis computed tomography. Bộ môn CĐHA ĐHYD TP. HCM 10 ÑIEÄN QUANG VIEÄT .