多层螺旋CT对消化道穿孔的诊断价值探讨  

Discussion on the diagnostic value of multi-slice spiral CT for gastrointestinal perforation

作　　者：张雪 ZHANG Xue(Department of Radiology and Imaging,Huludao Central Hospital,Huludao 125000,China)

机构地区：[1]辽宁省葫芦岛市中心医院放射影像科,125000

出　　处：《中国实用医药》2023年第4期79-81,共3页China Practical Medicine

摘　　要：目的研究多层螺旋CT对消化道穿孔的诊断价值。方法180例疑似消化道穿孔患者作为研究对象,均采用多层螺旋CT进行诊断。将临床病理诊断结果作为金标准,分析多层螺旋CT对消化道穿孔的检出率及诊断效能(敏感度、特异度、准确度、阳性预测值、阴性预测值、约登指数、误诊率、漏诊率)。结果临床病理诊断结果为消化道穿孔患者178例,急性胰腺炎患者1例,急性胆囊炎患者1例。多层螺旋CT检出消化道穿孔患者174例,检出率为96.67%。多层螺旋CT诊断消化道穿孔的敏感度为97.75%(174/178)、特异度为100.00%(2/2)、准确度为97.78%(176/180)、阳性预测值为100.00%(174/174)、阴性预测值为33.33%(2/6)、约登指数为0.9775、误诊率为0(0/2)、漏诊率为2.25%(4/178)。结论通过多层螺旋CT对消化道穿孔进行诊断具有较高的检出率,可以将其作为主要的辅助诊断方式。Objective To study the diagnostic value of multi-slice spiral CT for gastrointestinal perforation.Methods 180 patients with suspected gastrointestinal perforation were used as study subjects,and all were diagnosed by multi-slice spiral CT.The clinicopathological diagnosis results were taken as the gold standard,the detection rate and diagnostic efficacy(sensitivity,specificity,accuracy,positive predictive value,negative predictive value,Jorden index,misdiagnosis rate,and leakage rate)of multi-slice spiral CT for gastrointestinal perforation were analyzed.Results Clinicopathological diagnosis resulted in 178 patients with gastrointestinal perforation,1 patient with acute pancreatitis,and 1 patient with acute cholecystitis.Multi-slice spiral CT detected 174 patients with gastrointestinal perforation,with a detection rate of 96.67%.The sensitivity of multi-slice spiral CT in diagnosing gastrointestinal perforation was 97.75%(174/178),specificity was 100.00%(2/2),accuracy was 97.78%(176/180),positive predictive value was 100.00%(174/174),negative predictive value was 33.33%(2/6),Youden's index was 0.9775,misdiagnosis rate was 0(0/2),and missed diagnosis rate of 2.25%(4/178),respectively.Conclusion Multi-slice spiral CT has a high detection rate in the diagnosis of gastrointestinal perforation,and can be used as a primary adjunctive diagnostic modality.

关 键 词：多层螺旋CT 消化道穿孔 胃穿孔 十二指肠溃疡穿孔 诊断 

分 类 号：R735.35[医药卫生—肿瘤]