双源CT在胃肠道穿孔定位诊断的应用  

The Application of Dual Source CT in the Diagnosis and Localization of Gastrointestinal Perforation

作　　者：兰国宾[1] 戴士林[1] 路凯[1] 郝泽普[1] 郭福庆[1] 王庆海[2] 冯娜娜[3] LAN Guo-bin;DAI Shi-lin;LU Kai;HAO Ze-pu;GUO Fu-qing;WANG Qing-hai;FENG Na-na(Imaging Center,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,Hebei Province,China;Traditional Chinese Medicine Classics Ward,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,Hebei Province,China;Research Office,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,Hebei Province,China)

机构地区：[1]河北省沧州中西医结合医院影像中心 [2]河北省沧州中西医结合医院中医经典病房 [3]河北省沧州中西医结合医院科研办,河北沧州061001

出　　处：《中国CT和MRI杂志》2024年第10期124-126,共3页Chinese Journal of CT and MRI

基　　金：河北省医学科学研究重点课题计划指导项目(20150543)。

摘　　要：目的 探讨双源CT在胃肠道穿孔定位诊断中的价值。方法选择我院2020年1月至2023年10月临床以胃肠道穿孔收治入院患者共124例,期间都先后进行了腹部X线平片和腹部双源CT检查,针对两种方法诊断的敏感性及定位诊断准确率进行对比研究。结果经手术证实确诊。124例中82例(66.13%)诊断为胃肠道穿孔,其中胃穿孔36例(43.90%),小肠穿孔30例(24.19%),阑尾炎并穿孔6例(4.84%),结肠穿孔10例(8.06%)。双源CT对胃肠道穿孔诊断敏感度为98.78%、准确率为98.39%,均明显高于腹部X线诊断68.29%的敏感度、72.58%的准确率,之间差异明显(P<0.05)。双源CT对胃穿孔、小肠穿孔、阑尾炎并穿孔、结肠穿孔检出率高于腹部X线,双源CT对腹腔游离气体检出率92.68%明显高于腹部X线的54.88%,差异明显(P<0.05)。结论双源CT对胃肠道穿孔有较高的诊断价值,定位准确,值得临床应用。Objective To explore the value of dual-source CT in the localisation and diagnosis of gastrointestinal perforation.Methods A total of 124 cases of patients admitted with gastrointestinal perforation were selected from January 2020 to October 2023,during which both abdominal X-ray film and abdominal dual-source CT examination were performed successively,and compa rative studies were conducted on the diagnostic sensitivity and localisation diagnostic accura cy of the two methods.Results The diagnosis of gastrointestinal perforation was confirmed by surgery in 82 of 124 cases(66.13%),including 36cases(43.90%) of gastric perforation,30 cases(24.19%) of small bowel perforation,6 cases(4.84%)of appendicitis with perforation,and 10 cases(8.06%) of colonic perforation.The sensitivity of dualsource CT for the diagnosis of gastrointestinal perforation was 98.78% and the accuracy rate was98.39%,which were significantly higher than that of abdominal X-ray diagnosis with a sensitivity of68.29% and an accuracy rate of 72.58%,and the difference between them was significant(P<0.05).The detection rate of dual-source CT for gastric perforation,small intestinal perforation,appendicitis with perforation and colonic perforation was higher than that of abdominal X-ray,and the detection rate of dual-source CT for free gas in the abdominal cavity was 92.68% significantly higher than that of abdominal X-ray at 54.88%,with a significant difference between them(P<0.05).Conclusion Dualsource CT has high diagnostic value for gastrointestinal perforation with accurate localisation,which is worthy of clinical application.

关 键 词：双源CT 腹部X线平片 胃肠道穿孔 

分 类 号：R573[医药卫生—消化系统]