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作 者:蔡昭[1] 丁皓[1] 黄磊[1] 沈达明[1] 唐健雄[1] 袁祖荣[1]
出 处:《外科理论与实践》2007年第6期580-583,共4页Journal of Surgery Concepts & Practice
摘 要:目的:研究左上腹肿块的CT定位诊断价值。方法:回顾性分析我院自2005年4月至2006年9月因胰、脾、胃交界区肿块而行手术探查的131例病例;通过分析CT影像中肿块中心层面所在位置和邻近脏器的形态改变,以确定肿块的来源;并与手术探查结果相对比,研究CT诊断的准确性和各类疾病之间肿块中心层面所在位置和邻近脏器形态改变的异同。结果:CT诊断左上腹肿块来源的准确性为81.7%,Kappa值为0.741。来源于胃部、肠道和后腹膜的肿块主要位于胰体上方(P值<0.05),而来源于胰腺和脾脏的肿块主要位于胰体下方(P值<0.05)。胃部肿块胃底形态改变的几率显著高于其他疾病(P值为0.001),而胰腺肿块胰腺形态改变的几率也显著高于其他疾病(P值为0.001)。结论:CT影像中肿块中心层面所在位置和邻近脏器的形态改变,对左上腹肿块的定位诊断有一定的价值。Objective To evaluate the role of computerized tomography(CT) in the localization and diagnosis of left upper abdominal masses. Methods The clinical data from 131 patients with left upper abdominal masses, surgically explored during the period from April 2005 to September 2006, were retrospectively analyzed. The origins of these masses were determined by analyzing the maximal plane of masses and the distortion of neighboring organs in CT scanning. The accuracy of CT diagnosis was further confirmed by the results of surgical exploration. Results The accuracy of CT diagnosis was 81.7%, with a Kappa value of 0.741.Masses derived from GI tract and retroperitoneum were mostly located above the pancreatic body (P〈0.05), while masses derived from the pancreas and the spleen were located beneath the pancreatic body (P〈0.05). Gastric distortions were frequently found within the gastric masses (P=0.001), while pancreatic distortions occurred mostly within the pancreatic masses (P=0.001). Conclusions CT scanning is the basic technique in diagnosing left upper abdominal masses. Furthermore, the localization of abdominal masses could be determined by analyzing the maximal plane of masses and the distortion of neighboring organs in the CT.
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