背景:很少有研究检查在门静脉气体(PVG)和肠气(PI)中观察到的对比增强计算机断层扫描(CT)发现与这些疾病的潜在疾病之间的关联。
目的:在本研究中,我们分析了这种关联,并报告了预测死亡率的结果.
方法:总的来说,诊断为PVG或PI的50例患者,在对比增强CT上观察到,在我们医院接受治疗。基于潜在的疾病,我们把病人分成三组,那些患有缺血性疾病的人,传染病,或胃肠扩张。此外,接受手术治疗或需要手术但不能手术的患者被分配到高危组(n=16),接受保守治疗的患者被分配到低危组(n=34).我们查看了病人的病历,实验室数据,和CT图像回顾性分析,并分析了CT表现之间的关系,潜在的疾病,以及在每种情况下与高风险或低风险组的关联。
结果:肠壁增强不良,肠系膜脂肪绞合,肝外PVG,高龄,和肾脏疾病与缺血性疾病显着相关(分别为p=0.02,p=0.02,p=0.005,p=0.008和p=0.049)。PI单独与胃肠扩张密切相关(p=0.009)。低风险组的患者在保守治疗下具有更有利的结果。在多变量分析中,肝外PVG是与高危人群相关的唯一因素(p=0.002).
结论:与缺血性疾病相关的肝外PVG是死亡率最强的预测因素。其他CT表现,虽然有助于诊断潜在的疾病,没有显著的预测因素。
BACKGROUND: Very few studies have examined the association between contrast-enhanced computed tomography (CT) findings observed in portal venous gas (PVG) and pneumatosis intestinalis (PI) and the underlying diseases in these conditions.
OBJECTIVE: In this study, we analyzed this association and report the findings for predicting mortality.
METHODS: Overall, 50 patients diagnosed with PVG or PI, observed on contrast-enhanced CT, underwent treatment at our hospital. Based on the underlying disease, we divided the patients into three groups, those with ischemic disease, infectious disease, or gastrointestinal dilatation. Furthermore, cases that underwent surgical treatment or needed surgery but were inoperable were assigned to the high risk group (n=16) and patients who received conservative treatment were assigned to the low risk group (n=34). We reviewed the patients\' medical charts, laboratory data, and CT images retrospectively, and analyzed the relationship between CT findings, underlying disease, and association with the high risk or low risk group in each case.
RESULTS: Poor enhancement of the intestinal wall, mesenteric fat stranding, extrahepatic PVG, advanced age, and renal disease were significantly associated with ischemic disease (p=0.02, p=0.02, p=0.005, p=0.008 and p=0.049, respectively). PI alone was strongly associated with gastrointestinal dilatation (p=0.009). Patients in the low risk group had more favorable outcomes with conservative treatment. In multivariate analysis, extrahepatic PVG was the only factor associated with the high risk group (p=0.002).
CONCLUSIONS: Extrahepatic PVG associated with ischemic disease was the strongest predictive factor of mortality. Other CT findings, though useful in diagnosing the underlying disease, were not significant predictive factors.