探讨MSCT依据肠管分布联合肠系膜血管走行对消化道出血精准定位的价值  

The Value of Multi-slice Computed Tomography Based on Intestinal Distribution Combined with Mesenteric Vascular Travel for Accurate Localization of Gastrointestinal Bleeding

作　　者：赵思祺 宫凤玲 于鹏 ZHAO Siqi;GONG Fengling;YU Peng(Department of Imaging Medical,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Department of Nuclear Medicine,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China;Graduate School,North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院医学影像中心,河北唐山063000 [2]华北理工大学附属医院核医学科,河北唐山063000 [3]华北理工大学研究生学院,河北唐山063000

出　　处：《CT理论与应用研究(中英文)》2025年第2期303-309,共7页Computerized Tomography Theory and Applications

摘　　要：目的:评价MSCT依据肠管分布联合肠系膜血管走行对消化道出血(GIB)精准定位的能力。方法:搜集2021年1月至2023年9月于我院临床诊断GIB并行腹部CT增强扫描且经手术或内窥镜确诊GIB病例的临床及影像资料,由两名观察者(副主任医师及以上)采用双盲法回顾性分析所有病例MSCT薄层轴位图像,记录有无GIB;出血病例采用两种观察方法确定出血部位,A组:依据肠管分布判断出血部位,B组:依据肠管分布联合肠系膜血管走行判断出血部位。比较两种方法的对GIB精准定位的能力。结果:经手术或内窥镜确诊GIB的病例130例,MSCT检出GIB 109例,准确率83.85%;A组(依据肠管分布)定位出血部位71例,定位准确率为65.14%;B组(依据肠管分布联合肠系膜血管走行)定位出血部位85例,定位准确率为77.98%,两组差异有统计学意义。结论:MSCT依据肠管分布联合肠系膜血管走行定位GIB部位的准确性优于单纯依据肠管分布。Objective:This study aimed to evaluate the accuracy of multi-slice computed tomography(MSCT) to locate gastrointestinal bleeding(GIB) based on intestinal distribution combined with mesenteric vascular travel.Methods:The clinical and imaging data of GIB cases diagnosed in our hospital between January 2021 and September 2023 were collected and confirmed by surgery or endoscopy by abdominal CT-enhanced scanning,Two associate chief physicians retrospectively analyzed the thin-slice axial images of MSCT in all cases using the double-blind method,and recorded the presence or absence of GIB.Two observation methods were used to determine the bleeding site;the bleeding site was judged according to the intestinal distribution(group A),and intestinal distribution combined with mesenteric vascular travel(group B).The accuracy of both methods to locate the GIB was compared.Results:There were 130 cases of GIB diagnosed by surgery or endoscopy,and 109 cases were detected by MSCT,with an accuracy rate of 83.85%.There were 71 cases in group A and 85 cases in group B,and the accuracy to locate the bleeding site was 77.98%,with a statistically significant difference.Conclusion:The accuracy of MSCT in locating GIB sites based on intestinal distribution combined with mesenteric vascular travel is better than that based on intestinal distribution alone.

关 键 词：GIB MSCT 定位 肠管分布 肠系膜血管走行 

分 类 号：R572[医药卫生—消化系统] R816[医药卫生—内科学]