多层螺旋CT并多平面重建技术在非裂孔性膈疝与膈膨升术前诊断中的应用  

Application of multi-slice spiral CT combined with multi-planar reconstruction in preoperative diagnosis of non-hiatal diaphragmatic hernia and diaphragmatic eventration

作　　者：赵智勇 闫玉昌[1] 关磊 金淑溶 潘振宇[1] Zhiyong Zhao;Yuchang Yan;Lei Guan;Shurong Jin;Zhenyu Pan(Department of Radiology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China;Department of Hernia and Abdominal Wall Surgery,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)

机构地区：[1]首都医科大学附属北京朝阳医院京西院区放射科,100043 [2]首都医科大学附属北京朝阳医院疝和腹壁外科,100043

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第2期228-233,共6页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的分析和探究多层螺旋CT并多平面重建技术在非裂孔性膈疝与膈膨升术前评价中的应用及临床意义。方法选取2017年8月至2023年8月于首都医科大学附属北京朝阳医院西院区行手术证实的非裂孔性膈疝27例、膈膨升11例患者,对其影像学资料、临床手术资料进行回顾性分析,总结易误诊点及鉴别点。应用多平面重建技术测量膈疝疝口左右径数值及前后径数值,并与术中测量的径线值进行比较,检验之间相关性。结果手术证实为膈疝27例患者中,经CT薄层扫描并多平面重建技术观察影像诊断为膈疝24例,影像诊断准确率为88.88%(24/27);手术证实为膈膨升11例患者中,经影像观察诊断为膈膨升8例,准确率为72.72%(8/11)。关于膈疝左右径值、前后径值,多层螺旋CT多平面重建上与术中测量的值比较,差异均无统计学意义(P>0.05);左右径值、前后径值各自间均具有较强相关性(r=0.97,0.99;均P<0.01)。结论多层螺旋CT在非裂孔性膈疝与膈膨升术前准确诊断中发挥重要作用,辅以多平面重建技术观察可明显提高术前诊断准确率。多平面重建可多角度显示膈肌形态,准确判断膈肌的完整性及分辨胸腹腔邻近结构,并在相应手术方式的选择及膈疝修补术前合适大小疝补片选择上有较大临床指导意义。Objective To analyze and explore the application and clinical significance of multi-slice spiral CT combined with multi-planar reconstruction in preoperative evaluation of non-hiatal diaphragmatic hernia and diaphragmatic eventration.Methods From August 2017 to August 2023,27 cases of non-hiatal diaphragmatic hernia and 11 cases of diaphragmatic eventration confirmed by surgery in the West Campus of Beijing Chaoyang Hospital,Capital Medical University were selected.The imaging data and clinical operation data were retrospectively analyzed,and the points of misdiagnosis and differentiation were summarized.The left-right diameters and the anterior-posterior diameters of diaphragmatic hernia were measured by multi-planar reconstruction technique,and were compared with the diameters measured during operation,and the correlation between them was tested.Results Among 27 cases of diaphragmatic hernia confirmed by operation,24 cases were diagnosed as diaphragmatic hernia by thin-slice CT scanning and multi-planar reconstruction,and the accuracy rate of image diagnosis was 88.88%(24/27).Of the 11 cases of diaphragmatic eventration confirmed by operation,8 cases were diagnosed as diaphragmatic eventration by imaging observation,and the accuracy rate was 72.72%(8/11).In terms of the left-right diameters and the anterior-posterior diameters of diaphragmatic hernia,there was no significant difference between the values measured by multi-planar reconstruction technique and those measured during operation(P>0.05).There was a strong correlation between the left-right diameter and the anterior-posterior diameter(r=0.97,0.99;both P<0.01).Conclusion Multi-slice spiral CT plays an important role in the accurate preoperative diagnosis of non-hiatal diaphragmatic hernia and diaphragmatic eventration.The accuracy of preoperative diagnosis can be significantly improved by using multi-planar reconstruction technology.Multi-planar reconstruction can display the shape of diaphragm from multiple angles,accurately judge the integrity of diap

关 键 词：非裂孔性 膈疝 膈膨升 多层螺旋CT 多平面重建技术 疝修补术 

分 类 号：R656.21[医药卫生—外科学]