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目的 探讨血管、腹膜及肠系膜源性急腹症的MSCT表现特点及应用价值.方法 回顾性分析37例经影像及临床证实的血管、腹膜及肠系膜源性急腹症MSCT平扫、增强及多种后处理技术成像资料.结果 动脉瘤破裂并假性动脉瘤6例,发生在腹主动脉4例,腹腔干、左髂总动脉各1例;CT平扫表现为紧贴主动脉壁的软组织肿块影,增强后对比剂自主动脉腔溢出壁外进入动脉瘤外的血肿包块;腹主动脉夹层8例,CT增强7例见真假“双腔”,1例见腔内新月形无强化的稍高密度影,提示壁内血肿;血管栓塞16例,包括肠系膜上动、静脉栓塞6例,肾动脉栓塞3例,脾动脉栓塞2例,门静脉血栓形成5例,CT平扫2例表现为相应动脉或静脉内稍高密度影,3例为等密度,增强扫描均呈血管腔内充盈缺损;肠系膜扭转3例,CT增强扫描示肠系膜及其血管呈“旋涡征”改变;肠系膜脂膜炎2例,肠系膜密度增高呈雾状,周边见“假包膜征”,病变中可见“脂环征”及多发小结节;原发性化脓性腹膜炎2例,表现为腹腔积液、积气,网膜、肠系膜密度增高、水肿,腹膜多发脓腔形成.结论 MSCT增强及CTA重组是诊断血管源性急腹症重要技术;合适的窗宽、窗位可以增加腹膜、肠系膜源性急腹症疾病诊断信息;肠系膜局部雾状密度增高,其中多发小结节影及纤维条索状密度增高影,边缘有“假包膜征”和“脂环征”是诊断肠系膜脂膜炎依据.“,”Objective To study characteristics and application value of multi-slice spiral CT (MSCT) of angi.ogenic,peritoneum and mesangial acute abdomen.Methods retrospectively analysed 37 cases of angiogenic,peritoneum and mesangial acute abdomen confirmed by imaging or clinic.All cases underwent MSCT scan,including plain scan,enhanced scan and variety of CT post-processing.Results In six cases artery aneurysm was raptured,with pseudoaneurysms located in the abdominal aorta(4 cases),celiac trunk (1) and left common iliac artery(1).The imaging findings of CT plain scan included a soft tissue mass close to the aortic wall and a hematoma mass of aneurysm filled by contrast agent.In eight cases was aortic dissection,seven cases with true and false “double cavity” and one case with the crescent-shaped cavity without enhancement of slightly higher density(suggesting intracranial hematoma) can been seen from CT enhancement.sixteen cases appeared to possess vascular embolization,including superior mesenteric arterial venous embolization (6),renal artery (3 ),splenic artery(2) and portal vine (5 cases).The imaging finding of portal vein showed that two cases appeared to have a slightly higher density in the arterial or venous phase and three cases appeareded isodense on CT plain scan,while intravascular filling defects were seen in enhanced scan.Three cases with reversed mesentery appeareded “whirlpool sign” formed by the mesenteric and its vessels.Two cases with mesenteric panniculitis appeared to have cloudy increased-density of the mesentery,the surrounding “pseudocapsule sign”,“fat ring sign” in lesion and multiple small nodules.6.Two cases with primary suppurative peritonitis presented with ascites and gas;Omental mesangial had increased-density and edema;peritoneal acute abdomen had multiple abscess formation.Conclusion MSCT enhancement and CTA reconstruction are important diagnostic technology for angiogenic acute abdomen.Proper window width and window level can provide the diagnosis imformation of peritoneal and mesenteric acute abdomen.It is the diagnostic basis of mesenteric panniculitis that include cloud-shaped increased-density of the mesentery,multiple nodules and fiber cord-like high density shadow and the edge of“pseudocapsule sign” and “fat ring sign”.