MSCT多平面重组诊断单纯性横膈网膜疝  

Simple omental diaphragmatic hernia:the diagnosic value of multiplanar reformation in multi-slice spiral CT examination

作　　者：毛齐心 曹和涛[2] 

机构地区：[1]江苏省海门市第三人民医院影像科,江苏海门226154 [2]江苏省南通大学附属医院CT&MRI室,江苏南通226001

出　　处：《医学影像学杂志》2014年第1期68-72,共5页Journal of Medical Imaging

摘　　要：目的探讨MSCT多平面重组(multiple planar reconstruction,MPR)诊断单纯性横膈网膜疝(simple omental diaphragmatic hernia,SODH)的价值。方法 31例SODH均行MSCT容积扫描并作亚毫米重组,3名不知手术结果的高年资医师回顾性分析横断位和MPR图像,以发现膈肌中断缺损、膈上脂肪疝囊、"狭颈征"及"阳性血管征"作为诊断SODH依据;横断位及MPR征象显示及诊断差异采用2检验。结果 31例SODH中Bochdalek疝15例、Morgagni疝4例、医源性膈疝3例、食管裂孔疝6例及腔静脉裂孔疝3例,膈肌中断缺损、膈上疝囊、"狭颈征"及"阳性血管征"横轴位和MPR依次分别显示:6例和22例(2=16.67,P<0.01)、31例和31例、6例和28例(2=31.52,P<0.01)及3例和11例(2=5.90,P<0.05)。横轴位诊断12例,MPR全部明确诊断(2=27.40,P<0.01)。结论 MSCT MPR清晰显示SODH多种特征性征象,对诊断具有决定意义。Objective To investigate the value of MSCT multiple planar reconstruction （MPR） in diagnosis of simple o mental diaphragmatic hernia （SODH）. Methods 31 cases of SODH image data were collected, of which 15 cases were Bochdalek hernia 15 cases, 4 cases were Morgagni hernia 4 cases （2 cases confirmed by surgery）, 3 cases were iatrogenic diaphragmatic hernia （1 case confirmed by surgery）, 6 cases were esophageal hiatal hernias （1 case confirmed by surgery） and 3 cases were vena cava hiatal hernias. All cases underwent MSCT volume scanning, and the submiliimeter reconstruc tion was made. Three experienced radiologists randomly analyzed the axial and MPR images. The diagnostic criteria for SODH included diaphragmatic discontinuity or defect, fat hernial sac above the diaphragm, the ＂ narrow neck signs＂ （her nial sac become thin waists shape in the diaphragmatic muscle plane） and the ＂positive vascular signs＂ （omental vascular through the diaphragmatic defect or hiatus into fat sac in chest）. The ;（2 was used to investigate the differences between axial and MPR images in detection of signs used for diagnostic criteria mentioned above and in diagnosis of SODH. Results In 31 cases SODH, diaphragmatic discontinuity or defect, fat hernial sac above the diaphragm, the ＂narrow neck signs＂ and the ＂positive vascular signs＂ were identified in 6 cases, 31 cases, 6 cases and 3 cases by axial images, respectively and in 22 cases （X2 =16.67, P =0.01）, 31 cases, 28 cases （X2 =31.52, P 〈0.01） and 11 cases （X2 =5.90, P =0.05） by MPR images respectively. 12 cases of SODH were diagnosed by axial images and all cases by MPR images （X2 = 27.40, P =0.01）. Conclusion MSCT MPR can clearly display many characteristic signs of SODH, which is decisive for the diag nosis.

关 键 词：疝 横膈 脂肪 网膜 体层摄影术 x线计算机 多平面重组 

分 类 号：R655.6[医药卫生—外科学]