肠及肠系膜损伤CT表现对判断手术治疗的指导价值  

The evaluation of surgical indications of bowel and mesenteric injury with CT

作　　者：李永霞 马跃虎 刘柱 马新宁 

机构地区：[1]上海梅山医院放射科,江苏南京210039

出　　处：《实用放射学杂志》2012年第2期223-226,共4页Journal of Practical Radiology

摘　　要：目的探讨根据肠及肠系膜损伤CT表现判断是否需要手术治疗的指导价值。方法回顾性分析48例肠及肠系膜损伤患者的临床资料及CT表现，26例手术治疗，保守治疗22例。2名放射科医师根据CT表现判断是否需要手术治疗，以患者的最终诊断和治疗结果为标准，使用SPSSl3．o进行ROC曲线分析。阅片者间差异性评价采用Kappa一致性检验。结果肠管连续性中断和肠系膜血管内造影剂外溢只见于手术组，腹腔游离气体多见于手术组。2位医师根据CT图像判断是否需要手术治疗，ROC曲线分析准确性较高（曲线下面积Az值均〉O．9）。2位医师之间一致性分析结果为中、高度一致。结论根据CT征象可较准确地判断肠及肠系膜损伤的手术指征。Objective To evaluate the vaue of CT examination for surgical indications of bowel and mesenteric injury. Methods The clinic and CT data of 48 patients with bowel and mesenteric injury were retrospectively analysed. Of 48 cases, 26 cases under- went surgical operation and 22 cases were treated conservatively. Surgical indications was evaluated independently by two experi- enced radiologists according to CT findings, and based the final treating results of the patients, receiver operator characteristic （ROC） curve analysed with software SPSS13.0 was done, the different results between the two readers was evaluated with Kappa test. Re- suits Bowel wall discontinuity and mesenteric vessel extravasation of contrast medium were only presented in the patients needed surgical treatment and the cases with pneumoperitoneum required surgical management mostly. The Az of the area under the ROC curve in determining surgical treatment for the two observers was more than 0.9, which showed that the accuracy in diagnosing sur- gically important bowel and mesenteric injury was good, Kappa index test was modarate. Conclusion CT examination is helpful in evaluating the surgical indications for bowel and mesenteric injury.

关 键 词：腹部 肠 肠系膜 损伤 体层摄影术 X线计算机 

分 类 号：R572[医药卫生—消化系统] R572.3[医药卫生—内科学]