MSCT features of pneumatosis cystoides intestinalis and their diagnostic value
RONG Bingshui1 ZHANG Li2
1. Department of Medical Imaging,2. Department of Gastroenterology,Beijing Shijingshan Hospital,Teaching Hospital Affiliated to Capital Medical University,Beijing 100043,China
Abstract：Objective To analyze the MSCT characteristics of patients with pneumatosis cystoides intestinalis (PCI) in order to advance our understanding of the disease.Methods The clinical and MSCT examination data of 21 patients with PCI admitted to Beijing Shijingshan Hospital between January 2008 and January 2020 was analyzed retrospectively,while the imaging features of MSCT,experience and lessons from clinical diagnosis were summarized.Results Among the 21 cases of PCI,there was abdominal distension discomfort,intermittent dull pain and spontaneous relief in 7 cases,nausea and vomiting in 2 cases,stop of defecation and exhaust in 8 cases,and abdominal pain after colonoscopy and lithotripsy in 2 cases.The lesions were located in small intestines in 5 cases,in the ascending colon and cecum in 4 cases,in the ascending colon and transverse colon in 3 cases,in the transverse colon in 2 cases,in the sigmoid colon in 7 cases.PCI was accompanied by free abdominal gas in 13 cases,and by superior mesenteric vein,spleen vein and portal vein pneumatosis in 1 case.MSCT showed single empty bubbles and multiple “clustered”“beaded”“annular” and “banded” low density gas shadows along the intestinal curved contour submucosa and/or subserosal.Intestinal contents were located in the center of the intestine,and partial signs of intestinal wall stratification were found.Multiple spot and flaky gas shadows were observed in the fat space of the abdomen of patients with free gas.Of the 21 cases,7 cases were definitely diagnosed by MSCT and were cured with conservative non-surgical treatment.Conclusions PCI has some specific features in the examination of MSCT.The combination of multiplanar reconstruction (MPR) with window-width and window-position technique can facilitate diagnosis and show conditions of the surrounding tissues,providing important clues for clinical treatment.
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2020, Vol. 31 
