动态电影排粪造影诊断出口梗阻型便秘的价值  

Value of Dynamic Film Defecography in Diagnosis of Outlet Obstruction Constipation

作　　者：刘静[1] 詹玮[2] 廖欣[1] 陈佳妮[1] 胡建[1] 程天江 焦俊[1] 

机构地区：[1]贵州医科大学附院影像科,贵州贵阳550004 [2]贵州医科大学病理生理学教研室,贵州贵阳550004 [3]安顺市人民医院影像科,贵州安顺561000

出　　处：《贵阳医学院学报》2016年第5期587-589,583,共4页Journal of Guiyang Medical College

摘　　要：目的:探讨动态电影排粪造影(DFG)诊断出口梗阻型便秘的价值。方法:收集100例行DFG检查病例的相位摄片法图像和动态电影法截图,计算两种摄片方法诊断出口梗阻型便秘征象(耻骨直肠肌肥厚症、会阴下降、盆底疝、直肠内套叠、肛门括约肌失迟缓、直肠前突、盆底痉挛综合征及骶直分离)的灵敏度、漏诊率和诊所指数及Youden指数,计算各征象的诊断效能,同时记录动态电影法发现新解剖结构紊乱的病例。结果:与相位摄片法比较,动态电影法在诊断耻骨直肠肌肥厚症、会阴下降、盆底疝、直肠内套叠、肛门括约肌失迟缓具有较高诊断效能和较低的漏诊率;动态电影法发现17例新的解剖结构紊乱,其中盆底后疝16例,直肠后突1例。结论:动态电影DFG诊断功能性出口梗阻型便秘疾病效果优于相位摄片DFG。Objective： To investigate the value of dynamic film defecography（ DFG） in the diagnosis of outlet obstruction constipation. Methods： Phase radiography image and dynamic cine screenshots were collected from 100 cases of patients undergoing routine DFG examination. The diagnostic efficacy of the two kinds of perturbation methods in diagnosis of some symptoms of outlet obstructive constipation,including hypertrophy of the pubic,perineal descent,pelvic floor hernia,intrarectal invaginate,anal sphincter achalasia,rectocele,spastic pelvic floor syndrome. Meanwhile,the cases of new-finding anatomical structure disorder through dynamic film defecography were recorded. Results： Compared with the phase radiography image method,the dynamic film method had a higher diagnostic efficacy and a lower rate of missed diagnosis in the diagnosis of the patients with hypertrophy of the pubic,perineal descent,pelvic floor hernia,intrarectal invaginate and anal sphincter achalasia. 17 new cases of anatomical structure disorder through dynamic film defecography were found,in which there were 16 cases of pelvic floor hernia and 1 case of rectal posterior process. Conclusion： The film dynamic defecography in diagnosis of functional outlet obstruction constipation disease is better than phase X-ray defecography.

关 键 词：肠梗阻 便秘 骨盆底 排粪造影 动态电影 相位摄片 

分 类 号：R445.4[医药卫生—影像医学与核医学]