在有毒大结肠中计算机断层扫描时,缺少下腺和伪多与增加的死亡率有关
Joseph Gunderson1,2, David Schaub3, Christopher Miller3
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, USA. Joseph.Gunderson@UTSouthwestern.edu.
Abdominal radiology (New York)
|October 24, 2025
概括
计算机断层扫描 (CT) 显示有毒巨肠 (TM) 的常见发现,因原因而异. 在CT扫描中缺少下腺和伪多,表明TM患者的死亡风险增加.
科学领域:
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
- 腹部成像 腹部成像 腹部成像
背景情况:
- 计算机断层扫描 (CT) 被广泛用于腹部病理.
- 有毒大结肠 (TM) 的CT特征没有得到很好的描述.
- 了解TM中的CT发现对于诊断和预后至关重要.
研究的目的:
- 描述有毒巨结肠 (TM) 中常见的CT发现.
- 分析不同TM病因的CT发现的流行率.
- 确定CT发现对临床结果的影响,包括死亡率.
主要方法:
- 对70名患有TM的患者 (≥18岁) 进行了反差增强腹腔皮层CT的回顾性分析 (2014年1月 - 2024年6月).
- 独立审查CT图像以收集有关TM病因,人口统计,临床特征和治疗的数据.
- 评估结果:非手术解脱,结肠穿孔和30天死亡率.
主要成果:
- 常见的CT检测结果是:腹部损失 (95.7%),结肠膨胀>6厘米 (94.3%),壁壁加厚 (85.7%),脂肪分离 (85.7%).
- 病因:困难菌 (38.6%),缺血性结肠炎 (28.6%),炎症性肠道疾病 (25.7%).
- 缺少伪多和下水,与30天死亡率增加有关 (总体为32.9%).
结论:
- CT显示有毒巨肠 (TM) 的特征性发现.
- 炎症性肠病 (IBD) 和 Clostridioides difficile (C. diff) 是与慢性炎症相关的常见原因.
- 在CT上缺少下腺和伪多是TM死亡率增加的显著预测因素.
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