多排螺旋CT三维重建在肠道急腹症的应用价值  

THE APPLICATION OF 64-SLICE SPIRAL CT IN THE DIAGNOSIS OF ACUTE ABDOMEN OF INTESTINAL TRACT

作　　者：陈展航[1] 宋亭[1] 麦慧[1] 唐文艳[1] 彭晞[1] 

机构地区：[1]广州医科大学附属第三医院放射科,广东省广州市510150

出　　处：《中国煤炭工业医学杂志》2015年第9期1506-1509,共4页Chinese Journal of Coal Industry Medicine

摘　　要：目的探讨多排螺旋CT三维重建在肠道急腹症诊断中的应用价值。方法回顾分析112例经手术证实的肠道急腹症术前全腹CT、CTA及三维重建资料,其中45例仅行平扫检查,12例行CTA检查。手术证实肠梗阻53例,急性阑尾炎27例,肠道穿孔23例,肠系膜上动静脉栓塞6例,急性出血性肠道炎3例。结果 112例临床病因诊断符合率65.2%(73/112),总体CT诊断敏感性96.4%(108/112),特异性88.4%(99/112),其中合并腹腔积液46例、肠管坏死31例。肠梗阻CT敏感性100%,病因诊断率88.7%(47/53);急性阑尾炎27例,敏感性92.6%(25/27),特异性100%;肠道穿孔23例,敏感性91.3%(21/23),定位准确率90.5%(19/21);肠系膜上动静脉栓塞各3例,敏感性及特异性均100%;急性出血性肠炎敏感性100%,特异性66.7%(2/3)。结论多排螺旋CT结合后处理技术对肠道急腹症的病因诊断有较高敏感性和特异性,通常能于术前明确病因。Objective To explore the applied value of 64- slice spiral CT in the diagnosis of acute abdomen of intestinal tract. Methods A retrospective analysis was performed on the CT （or CTA ） and three - di- mensional reconstruction images of 112 cases proved acute abdomen of intestinal tract with emergent opera- tion, among of them, 45 cases only underwent plain CT scan and 12 cases underwent CTA scan, include intestinal obstruction in 53, acute appendicitis in 27, intestinal perforation in 23, SMA and SMV embolism in 6, acute hemorrhagic enteritis in 3. Results The causal accuracy of clinical diagnosis was 65.2% （73/ 112） and overall CT sensitivity was 96. 4% （108/112） and specificity was 88. 4% （ 99/112） in 112 cases, included abdominal effusion46 cases, intestinal necrosis 31 cases. CT sensitivity on intestinal obstruction was 100% and causal accuracy was 88.7% （47/53）. On acute appendicitis, the sensitivity was 92.6% （25/ 27 ）and specificity was 100% on CT; On intestinal perforation, the sensitivity was 91.3% （21/23）and loca- ted accuracy was 90.5% （ 19/21 ） ; On SMA and SMV embolism, the sensitivity and specificity were all 100% ; On acute hemorrhagic enteritis, sensitivity was 100% and specificity was 66.7% （2/3）. Conclusion Acute abdomen of intestinal tract has characteristic features on spiral CT, it usually can be made definite etiological diagnosis combine with CT processing technology before operation.

关 键 词：肠道急腹症 X线计算机体层摄影术 图像后处理 影像学诊断 

分 类 号：R816.5[医药卫生—放射医学]