超声与多层螺旋CT在血管源性急腹症患者诊断中的应用  

Application of ultrasound and multi-slice spiral CT in the diagnosis of vascular acute abdomen

作　　者：刘启球 何亚林 LIU Qi-qiu;HE Ya-lin(Department of Ultrasound,zhaoqing Gaoyao District Hospital of Traditional Chinese Medicine,Zhaoqing 526100,Guangdong,CHINA;Department of Imaging,zhaoqing Gaoyao District Hospital of Traditional Chinese Medicine,Zhaoqing 526100,Guangdong,CHINA)

机构地区：[1]肇庆市高要区中医院超声科,广东肇庆526100 [2]肇庆市高要区中医院影像科,广东肇庆526100

出　　处：《海南医学》2021年第7期874-877,共4页Hainan Medical Journal

基　　金：广东省肇庆市科技计划项目(编号:202004031395)。

摘　　要：目的研究超声与多层螺旋电子计算机断层扫描(CT)在血管源性急腹症患者诊断中的应用价值。方法回顾性分析肇庆市高要区中医院2018年3月至2020年4月收治的53例疑似血管源性急腹症患者的临床资料,所有患者均接受超声和多层螺旋CT检查,以手术病理诊断结果作为诊断标准。对比超声与多层螺旋CT检查对血管源性急腹症的诊断结果。结果53例疑似血管源性急腹症患者经手术病理诊断40例为血管源性急腹症(阳性),其中假性动脉瘤9例、腹主动脉瘤12例、血管栓塞14例、动脉夹层5例,余下13例为非血管源性急腹症(阴性);超声正确诊断43例(37例阳性+6例阴性),误诊7例,漏诊3例;多层螺旋CT检查正确诊断51例(39例阳性+12例阴性),误诊1例,漏诊1例;多层螺旋CT检查诊断的准确率与特异度分别为96.23%、92.31%,明显高于超声检查的81.13%、46.15%,差异有统计学意义(P<0.05);超声诊断的灵敏度、阴性预测值和阳性预测值分别为92.50%、66.67%、80.43%,与多层螺旋CT检查的97.50%、92.31%、97.50%相比,差异均无统计学意义(P>0.05)。结论超声与多层螺旋CT均是血管源性急腹症的重要影像学检查手段,但多层螺旋CT诊断的准确性和灵敏度更高。Objective To study the application value of ultrasound and multi-slice spiral computed tomography(CT)in the diagnosis of vascular acute abdomen.Methods The clinical data of 53 patients with suspected vascular acute abdomen treated in zhaoqing Gaoyao District Hospital of Traditional Chinese Medicine from March 2018 to April 2020 were analyzed retrospectively.All patients were examined by ultrasound and multi-slice spiral CT,and the results of surgical and pathological diagnosis were taken as diagnostic criteria.The diagnostic results of ultrasound and multi-slice spiral CT in vascular acute abdomen were compared.Results In the 53 patients with suspected vasogenic acute abdomen,40 were diagnosed as vasogenic acute abdomen(positive)by surgical pathology,including 9 cases of pseudoaneurysm,12 cases of abdominal aortic aneurysm,14 cases of vascular embolism,5 cases of arterial dissection,and the remaining 13 cases of non-vasogenic acute abdomen(negative);43 cases were correctly diagnosed by ultrasound(37 positive cases and 6 negative cases),7 cases were misdiagnosed,and 3 case was missed;51 cases(39 positive and 12 negative)were correctly diagnosed by multi-slice spiral CT,1 case was misdiagnosed,and 1 case was missed.The accuracy and specificity of multi-slice spiral CT were 96.23% and 92.31%,which were significantly higher than corresponding 81.13% and 46.15% of ultrasound(P<0.05);the sensitivity,negative predictive value and positive predictive value of ultrasonography were 92.50%,66.67% and 80.43%,as compared with corresponding 97.50%,92.31% and 97.50% of multi-slice spiral CT(all P>0.05).Conclusion Both ultrasound and multi-slice spiral CT are important imaging methods for angiogenic acute abdomen,but multi-slice spiral CT has higher accuracy and sensitivity in diagnosis.

关 键 词：血管源性急腹症 超声 多层螺旋电子计算机断层扫描 诊断价值 灵敏度 特异度 

分 类 号：R656.1[医药卫生—急诊医学]