多层螺旋CT及其重建技术在股疝诊断中的应用  

Application value of multi-slice spiral computed tomography in diagnosis of femoral hernia

作　　者：王盛甲 赵振国[1] 顾强[1] 文峰[1] 夏郁金 丁俞江 

机构地区：[1]上海市浦东新区人民医院放射科,上海201299

出　　处：《生物医学工程与临床》2015年第5期472-475,共4页Biomedical Engineering and Clinical Medicine

基　　金：上海市浦东新区卫生系统领先人才培养基金(PWR12010-02);上海市浦东新区人民医院重点学科群基金(PRxkq2013-03)

摘　　要：目的 探讨多层螺旋CT（MSCT）对股疝的诊断价值，以提高对该病的诊断水平。方法 选择19例经手术证实的股疝患者，其中男性2例，女性17例；年龄49 ～ 90岁，平均年龄70岁。回顾性分析其MSCT横断位及多平面重建（MPR）图像，并与手术结果对照分析。结果 右侧股疝9例，左侧股疝10例。CT表现为腹股沟区软组织密度、脂肪密度、混杂密度影，或显示为含气、含液的肠管，向上与腹腔相连通，疝囊均位于腹股沟韧带后方。疝内容物为小肠及系膜10例，仅为网膜5例，合并小肠及系膜、网膜2例，内容物为空肠、乙状结肠肠脂锤1例，仅为少量腹水1例。同时9例患者有小肠梗阻表现。CT诊断符合率100 %，与手术结果一致。结论 MSCT可以准确显示股疝的位置、形态、内容物、与周围结构之间的关系及继发征象，对其诊断及鉴别诊断具有重要价值，为评估风险、制定治疗方案提供重要信息。Objective To explore the diagnostic value of multi-slice spiral computed tomography（MSCT） in femoral hernia, and improve the level of diagnosis. Methods A total of 19 patients with femoral hernia were enrolled, included 2 males and 17 females, aged 49- 90 years old with mean age of 70 years old. The images of MSCT and multi-planar reconstruction（MPR） were retrospectively studied and compared with surgical results. Results There were 9 femoral hernias in the right groin and 10 femoral hernias in the left. Hernia contents were found in inguinal region on CT images, showed as soft tissue density, fat density and mixed density, or as gas or liquid-filled bowel. All hernias were connected upward with abdominal cavity, and all hernial sacs were located behind inguinal ligament. Hernia contents were small intestine and mesentery in 10 cases, omentum only in 5 cases, small intestine and mesentery were associated with omentum in 2 cases, jejunum and epiploic appendices of colon sigmoid in one case, and one case with only a little ascites. There were 9 cases with small intestinal obstruction. The diagnostic coincidence rate was 100 % with MSCT,which was proved by operation outcome. Conclusion It is demonstrated that MSCT could exactly display the location,morphology, hernia contents, adjacent structures as well as the complications of femoral hernia, and it plays an important role in diagnosis and differential diagnosis, which may provide important information for evaluating risk and making treatment plan.

关 键 词：股疝 计算机X线体层摄影术 影像诊断 

分 类 号：R656.2[医药卫生—外科学] R814.42[医药卫生—临床医学]