腹壁切口疝多层螺旋 CT 术前诊断价值  

Diagnostic value of multi-slice computed tomography in patients with incisional hernia before operation

作　　者：姚庆东[1] 程小杰[2] 张呈兵[1] 张东友[1] 周红丽[1] 韩瑞[1] 许崇永[3] 

机构地区：[1]武汉市第一医院放射科,湖北武汉430022 [2]武汉市中心医院核医学科 [3]温州医科大学附属第二医院放射科

出　　处：《实用放射学杂志》2015年第8期1294-1296,1300,共4页Journal of Practical Radiology

摘　　要：目的：探讨多层螺旋 CT（MSCT）对腹壁切口疝术前诊断价值。方法收集本院经手术病理证实的腹壁切口疝患者30例。所有患者均行 MSCT 检查,并行多平面重建（MPR）,21例行超声（US）检查；观察切口疝数目、部位、内容物、有无肠梗阻等并发症,比较 MSCT 横断位与 MPR 及 MSCT 与 US 在观察上述方面的差别。结果30例中,共有切口疝40处,MSCT 和 US 检出率分别为97.5%、56.0%,MSCT 较 US 检出更有优势（P=0.000）。MSCT 横断位与 MPR 检出孤立性切口疝无明显差异（P =1.000）,MPR检出2处或多处切口疝较横断面好（P =0.006）,且矢状位较冠状位更有优势（P =0.019）。此外,MSCT 准确显示切口疝并发症,包括肠梗阻7例,肠壁水肿缺血5例及疝口处转移灶1例,US 均未提示。结论 MSCT 对腹壁切口疝术前诊断及并发症显示具有重要价值,可为临床治疗提供参考。Objective To evaluate the diagnostic value of multi-slice computed tomography （MSCT）for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound （US）examinations.The value of transverse scan and MPRs ＆ MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias （P =0.000）.On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans （P = 1.000 ）.However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis （P =0.006）,and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias （P =0.01 9）.Furthermore,MSCT can exactly reveal the complications of incisional hernias （7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia）,which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.

关 键 词：切口疝 计算机体层成像 

分 类 号：R656.2[医药卫生—外科学]