Abstract:

Objective　To explore the MRI features and imaging mechanism of intestinal fecalith at different locations, and to raise the diagnosis accuracy rate of intestinal fecalith. Methods　A total of 23 cases of intestinal fecalith (including 13 males and 10 females, with a median age of 67 years old, 20 cases in the small intestine and 3 cases in the colon) underwent MRI examinations in Laiyang Central Hospital of Yantai from March 2016 to August 2022. The MRI features (T1WI and T2WI) of intestinal fecalith were summed up and analyzed combined with intraoperative findings. Results　All 23 cases of intestinal fecalith showed "coke" sign (irregular low signal) on T2WI. The signals on T1WI showed as follows: (1) characteristic "empty shell" sign (internal low signal and peripheral ringlike high signal) in 14 cases, of which 13 cases were located in the small intestine and 1 case was located in the flexura hepatica coli; (2) mixed slightly high signal in 5 cases, all located in the small intestine (4 cases in the jejunum and 1 case in the ileum); (3) homogeneous low signal in 4 cases, 2 cases in the small intestine and 2 cases in the left hemicolon. Conclusions　Intestinal fecalith at different locations show "coke" sign on T2WI. The signals on T1WI are complex and diverse, and are often manifested by "empty shell" sign. It is useful to reduce the misdiagnosis and missed diagnosis by fully recognizing MRI features of intestinal fecalith.

Key words:

Intestinal fecalith, Intestinal obstruction, Magnetic resonance imaging, Diagnosis

摘要：

目的　分析不同部位肠粪石的磁共振成像（MRI）信号特征，提高医师对肠粪石的诊断准确率。方法　对2016年3月至2022年8月烟台市莱阳中心医院收治的23例肠粪石（男13例，女10例，中位年龄67岁，20例小肠粪石、3例结肠粪石）进行MRI，结合手术所见，总结分析肠粪石T1WI和T2WI的信号特征。结果　23例肠粪石在T2WI均呈“焦炭样”征象（即不规则形低信号）。T1WI信号可表现为：（1）特征性“空壳征”（即内部低信号外周环形高信号）14例，其中13例位于小肠，1例位于结肠肝曲；（2）混杂稍高信号5例，均位于小肠（空肠4例，回肠1例）；（3）均匀低信号4例，位于小肠和左半结肠各2例。结论　不同部位肠粪石在T2WI均呈“焦炭征”，T1WI信号复杂多样，以“空壳征”表现多见；充分认识肠粪石的MRI信号特征，有助于减少误诊和漏诊。

关键词:

肠粪石, 肠梗阻, 磁共振成像, 诊断