多层螺旋CT在急性肠扭转诊断和鉴别诊断中的应用研究  

Application of Multilayer Spiral CT in the Diagnosis and Differential Diagnosis of Acute Intestinal Volvulus

作　　者：陆荣平 孙志远 陈立顶 Lu Rongping;Sun Zhiyuan;Chen Liding(Imaging Department of Taizhou Integrated Traditional Chinese and Western Medicine Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]江苏省泰州市中西医结合医院影像科,江苏泰州225300

出　　处：《生命科学仪器》2024年第1期23-25,共3页Life Science Instruments

摘　　要：目的探讨多层螺旋CT(MSCT)在急性肠扭转诊断和鉴别诊断中的应用价值。方法采用回顾性研究的方法,选取2018年1月至2023年5月期间医院收治的疑似急性肠扭转患者50例为研究对象,进行手术治疗前,均行MSCT检查。分析入选患者的临床诊断或手术结果、MSCT特征。以手术结果为金标准,评估MSCT在诊断急性肠扭转中的效能。结果50例患者均成功进行手术治疗,其中49例手术病理诊断结果证实为肠扭转,1例为结肠癌。49例患者中,小肠扭转31例、乙状结肠扭转17例,结肠回盲部1例,扭转角度为180°-720°。41例患者(占82.00%)MSCT征象均呈漩涡征,36例患者(占72.00%)MSCT征象均呈鸟嘴征。以手术病理结果为金标准,MSCT诊断急性肠扭转的灵敏度为97.96%(48/49),特异度为100.0%(1/1),准确度为98.00%(49/50);经过Kappa一致性检验,得出K值=0.658,提示MSCT诊断急性肠扭转与手术病理结果具有较好的一致性(P<0.001)。结论MSCT在诊断和鉴别急性肠扭转患者中应用价值良好,且具有操作简单、图像清晰等优势,值得临床推广应用。Objective:To investigate the diagnostic and differential value of multilayer CT(MSCT)for acute volvulus.Methods:In a retrospective study,50 patients with suspected acute intestinal torsion admitted in our hospital from January 2018 to May 2023 were selected for MSCT before surgical treatment.Analyze the clinical diagnosis or surgical results and the MSCT characteristics of the selected patients,and evaluate the efficacy of MSCT in the diagnosis of acute intestinal volvulus using the surgical results as the gold standard.Results:In this study,50 patients were successfully treated,49 patients had volvulus,and one patient had colon cancer.49 patients were classified as small intestinal volvulus(n=31),sigmoid volvulus(n=17)and ileocecum(n=1)with torsion angles from 180 to 720,41 patients(82.00%)patients showed vortex signs,36 patients(72.00%)showed beak signs.Using the surgical pathology result as the gold standard,the sensitivity of MSCT for acute intestinal torsion was 97.96%(48/49),the specificity of 100.0%(1/1),the accuracy was 98.00%(49/50),and the K value=0.658,indicating the consistency of MSCT and surgical pathology results(P<0.001).Conclusion:MSCT has good application value in diagnosis and differentiating patients with acute volvulus,and has the advantages of simple operation and clear image,which has certain application value.

关 键 词：急性肠扭转 多层螺旋CT 急腹症 

分 类 号：R656[医药卫生—外科学]