多层螺旋CT增强扫描联合后处理技术在肠梗阻病因诊断中的应用价值  

Application value of enhanced multi-slice spiral CT scan combined with post-processing techniques in etiological diagnosis of intestinal obstruction

作　　者：郑玉飞[1] 朱丽丽[1] 徐辉[2] ZHENG Yu-fei;ZHU Li-li;XU Hui(Department of Radiology,Jurong People's Hospital,Jurong 212400,China;Department of Radiology,Nanjing Hospital Affiliated to Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]江苏省句容市人民医院影像科,句容市212400 [2]南京医科大学附属南京医院放射科,江苏省南京市210006

出　　处：《广西医学》2020年第15期1931-1934,共4页Guangxi Medical Journal

摘　　要：目的探讨多层螺旋CT增强扫描联合后处理技术在肠梗阻病因诊断中的应用价值。方法纳入60例肠梗阻患者,术前均行CT全腹部平扫以及增强三期扫描,并采用多种后处理技术重建图像,分析肠梗阻病因及有无肠缺血。以临床治疗及手术情况为标准,评价多层螺旋CT增强扫描联合后处理技术在诊断肠梗阻病因及评价肠缺血中的价值。结果60例肠梗阻患者中,常规横断位图像及其联合后处理图像正确诊断肠梗阻病因各35例、55例,正确率分别为58.3%、91.7%。粘连性肠梗阻36例,CT正确诊断32例,3例肠壁黏膜慢性炎症及1例小肠憩室炎导致的粘连性肠梗阻术前未能正确诊断;肠道肿瘤导致肠梗阻15例,腹股沟疝导致的肠梗阻4例,腹股沟疝所致绞窄性肠梗阻1例,术前CT均正确诊断;阑尾炎及阑尾脓肿导致肠梗阻3例,CT正确诊断2例,1例阑尾脓肿导致肠梗阻误诊为结肠肿瘤导致肠梗阻;血运性肠梗阻1例,CT正确诊断,曲面重建图像可清晰地显示肠系膜上动脉血栓;小肠粪石导致肠梗阻1例,临床治疗前CT正确诊断。结论多层螺旋CT增强扫描联合多种后处理技术,对肠梗阻病因的诊断正确率较高,同时能评估有无肠缺血存在,临床应用价值高。Objective To explore the application value of enhanced multi-slice spiral CT scan combined with post-processing techniques in the etiological diagnosis of intestinal obstruction.Methods Sixty patients with intestinal obstruction were enrolled and underwent preoperative plain and triple-phase contrast enhanced abdominal CT scan using various post-processing techniques for image reconstruction,the etiology of intestinal obstruction as well as the presence/absence of intestinal ischemia was analyzed.Using clinical therapy and operation conditions as the criteria,the value of multi-slice spiral contrast enhanced CT scan combined with post-processing techniques in diagnosing the etiology of intestinal obstruction as well as assessing intestinal ischemia was evaluated.Results Of the 60 cases of intestinal obstruction,35 were correctly diagnosed by conventional axial images and 55 by conventional axial images combined post-processing images,with the correct rates of 58.3% and 91.7% respectively.Of 36 cases of adhesive intestinal obstruction,32 were correctly diagnosed by CT,three of chronic inflammation of intestinal mucous membrane and one of adhesive intestinal obstruction caused by small intestinal diverticulitis were not identified accurately before operation;fifteen cases of intestinal obstruction resulting from intestinal tumors,four cases of intestinal obstruction caused by inguinal hernia,and one case of strangulated intestinal obstruction due to inguinal hernia were identified accurately by preoperative CT;of three cases of intestinal obstruction resulting from appendicitis and appendiceal abscess,two were identified accurately by CT,and one of intestinal obstruction due to appendiceal abscess was misdiagnosed as intestinal obstruction due to colon tumor;one case of vascular intestinal obstruction,accurately diagnosed by CT,displayed superior mesenteric artery thrombosis on surface reconstruction images;and one case of intestinal obstruction due to small intestinal fecalith was identified accurately7 by CT befo

关 键 词：肠梗阻 多层螺旋CT 增强扫描 后处理技术 病因 肠缺血 

分 类 号：R574.2[医药卫生—消化系统] R445.3[医药卫生—内科学]