Abstract: Objective: To analyze the image performance of colon innervation defect with multilayer spiral CT (MSCT) and clinical manifestations, summarize its image characteristics and make correct diagnosis. Methods: The clinical features of colonic innervations deficiency present with prolonged constipation and incomplete ileus. MSCT imaging data using GE gem energy spectrum, CT 750 HD, and Philips MSCT. 1 mm layer thickness, 1 mm layer spacing, tube voltage, 120 kV, automatic tube current from the diaphragm to the bilateral pubic joint. Scan in the natural state of the intestine (No bowel preparation, no cleansing enema and bowel cleansing), after scanning, conduct MPR 3D reconstruction at the CT workstation, and the reconstructed data were archived and analyzed in the PACS system. Clarify the intestinal location of the diseased segment, measure intestinal wall thickness of dilated segment and narrow segment respectively; measure intestinal tube length of diseased segment (narrow segment); observe intestinal peristalsis with multiple-stage MSCT; and observe intestinal blood transport through enhancement. Results: The clinical features of colon innervations defect was constipation and incomplete ileus. In this study group, there were 5 adult patients with colon innervations defect, and the lesion site was located in the spleen and descending colon respectively, among which the diseased segment was located in 3 cases and the spleen was located in 2 cases of colon; MSCT shows relative narrowing of the colon and expansion of the proximal colon; The intestinal wall thickness was normal in the diseased area, and the intestinal wall thickness of the dilated colon section was normal or somewhat thickened, and the thickened intestinal wall in this group is less than 0.9 cm; The intestinal length of the diseased segment in this group was somewhere between 4.3~8.6 cm. The MSCT enhancement scan of mesangic vessels and mesangial density showed no abnormal changes, and no abnormal enhancement of the colon wall in the diseased section, suggesting normal blood supply; MSCT enhanced scan showed rigidity and no peristalsis in the diseased segment, suggesting loss of peristaltic function in the diseased segment. Conclusion: Colonic innervations defect has imaging findings of characteristic post dilating stenosis and clinical features of prolonged constipation and incomplete obstruction in adults, The MSCT combined with clinical data was able to indicate the diagnosis of colonic innervations defect before surgery.