多层螺旋CT与超声在诊断急诊老年血管源性急腹症中的应用  

Application of multi-slice spiral CT and ultrasonography in the diagnosis of acute vasogenic abdominal disease in senile patients

作　　者：李茂胜 谢微波 Li Maosheng;Xie Weibo(Department of Radiography,Second People＇s Hospital,Liangjiang New District of Chongqing,Chongqing 401123,China)

机构地区：[1]重庆两江新区第二人民医院放射科,重庆401123

出　　处：《海军医学杂志》2018年第4期348-350,372,共4页Journal of Navy Medicine

摘　　要：目的比较多层螺旋CT(multi-slice CT,MSCT)与超声在诊断急诊老年血管源性急腹症中的应用价值。方法选取重庆两江新区第二人民医院放射科2015年4月至2017年4月诊断为血管源性急腹症的老年患者60例为研究对象,均在手术前接受MSCT扫描与超声检查,以手术病理结果为诊断标准。计算MSCT扫描与超声检查诊断老年血管源性急腹症的灵敏度、特异度、阳性预测值、阴性预测值、总符合率、Kappa值。结果经手术病理证实,44例患者确诊为血管源性急腹症。超声诊断老年血管源性急腹症的灵敏度、特异度、阳性预测值、阴性预测值、总符合率、Kappa值分别为81.8%、87.5%、94.7%、63.6%、83.3%、0.62。MSCT诊断老年血管源性急腹症的灵敏度、特异度、阳性预测值、阴性预测值、总符合率、Kappa值分别为95.5%、93.8%、97.7%、88.2%、95.0%、0.87。MSCT诊断老年血管源性急腹症的灵敏度、总符合率明显高于超声检查,差异有统计学意义(P<0.05)。结论 MSCT与超声在老年血管源性急腹症检查方面均具有较好的成像效果,但MSCT具有更高灵敏度与准确性。Objective To compare the clinical value of multi-slice spiral CT （MSCT） and ultrasonography in the diagnosis of acute vasogenic abdominal disease in senile patients. Methods Sixty senile patients with suspected acute vasogenic abdominal disease who were admitted into the Department of Radiography, Second People＇s Hospital, Liangjiang New District of Chongqing from April 2015 to April 2017 were selected as research subjects. All the patients were examined before surgery by MSCT scan and ultrasonography, and pathological results were used as diagnostic golden standards. The sensitivity, specificity, positive predictive value, negative predictive value, total conformity and Kappa value of MSCT scanning and ultrasonography in the diagnosis of acute vasogenic abdominal disease in senile patients were calculated and evaluated against the surgical results. Results Pathological results identified that 44 patients were confirmed as the senile acute vasogenic abdominal disease. The sensitivity, specificity, positive predictive value, negative predictive value, total conformity and Kappa value of ultrasonography in the diagnosis of acute vasogenic abdominal disease in senile pa tients were 81.8% , 87.5% , 94.7% , 63.6% , 83.3% and 0.62 respectively, while those of MSCT were 95.5% , 93.8% , 97.7% , 88.2% , 95.0% and 0.87 respectively. The sensitivity and total conformity of MSCT in the diagnosis of acute vasogenic abdominal disease in senile patients were significantly higher than those of ultrasonography, with statistical significance （ P 〈 0.05 ）. Conclusion The imaging results of both MSCT and ultrasonography are all good in the detection of acute vasogenic abdominal disease in senile patients, but the sensitivity and accuracy of MSCT are relatively higher.

关 键 词：急腹症 血管病变 老年 多层螺旋CT 超声 

分 类 号：R445.3[医药卫生—影像医学与核医学] R445.1[医药卫生—诊断学]