螺旋CT对胃、十二脂肠穿孔的诊断价值  

Usefulness of spiral CT for diagnosing gastroduodenal perforation

作　　者：侯茂青[1] 侯志强[1] 曾亚军[1] 彭昊[1] 

机构地区：[1]湖南省安仁县人民医院放射科,湖南安仁423600

出　　处：《实用医学影像杂志》2009年第3期168-170,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨螺旋CT对胃、十二指肠穿孔的诊断价值。方法回顾性分析经手术病理证实的56例胃、十二指肠穿孔患者的临床资料、传统X线改变和CT征象。56例中男46例,女10例,年龄9～79岁,平均46.2岁;胃溃疡穿孔20例,胃癌穿孔5例,十二指肠球部溃疡穿孔25例,外伤性胃穿孔2例,外伤性十二指肠穿孔4例。全部病例术前均经常规X线透视、摄片与CT检查。结果在56例中,常规X线透视与摄片仅发现19例膈下游离气体,而在CT像上有40例可见腹腔内形态、位置、大小不一的游离气体影,23例伴腹膜腔积液现象,10例仅见网膜囊内包裹性改变。结论CT能发现常规X线透视及摄片无膈下游离积气时的胃、十二指肠穿孔,具有早期诊断价值。Objective To discuss the usefulness of spiral CT for diagnosing gastroduodenal （GD） perforation.Methods Fifty-six patients （46 men,10 women;aged 9-79 years; mean age,46.2 years）with surgically and pathologically proved GD perforations which comprised 20 gastric ulcer,5 gastric cancer,25 duodenal bulb ulcer,2 traumatic gastric perforations,and 4 traumatic duodenal perforations underwent conventional radiologic and spiral CT examinations before the operation.The clinical,radiologie and CT findings in all patients were retrospectively analyzed.Results Among 56 cases,conventional X-ray fluoroscopy and radiograph showed subdiaphragmatic free gas only in 19 cases but CT scans showed free pneumoperitoneum with different shape,site and size in 40 cases,associated free intraperitoneal fluid in 23 cases and encapsulation of omental bursa in 10 cases.Conclusion CT scan is more valuable than conventional X-ray fluoroscopy and radiography in the early diagnosis of gastroduodenal perforation without subdiaphragmatic free gas.

关 键 词：溃疡穿孔 外伤性穿孔 X线透视 摄片 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学] R656.6[医药卫生—临床医学]