[1]董军强,郭 宁.64排螺旋CT静脉血管造影在小肠梗阻临床诊断中的应用研究*[J].陕西医学杂志,2019,(6):751-754.
　DONG Junqiang,GUO Ning.Application of 64-slice spiral CT venography in the clinical diagnosis of small bowel obstruction[J].,2019,(6):751-754.
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64排螺旋CT静脉血管造影在小肠梗阻临床诊断中的应用研究*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年6期
页码:
751-754
栏目:
临床研究
出版日期:
2019-06-05

文章信息/Info

Title:
Application of 64-slice spiral CT venography in the clinical diagnosis of small bowel obstruction
文章编号:
DOI:〖HT5K〗10.3969/j.issn.1000-7377.2019.06.019
作者:
董军强; 郭 宁
空军军医大学西京医院放射科（西安710032）
Author(s):
DONG Junqiang;  GUO Ning
Radiology Department of Xijing College, Air Force Medical University(Xi’an 710032）
关键词:
小肠梗阻; 影像学诊断; 多层螺旋CT; CT血管造影; 部位; 程度; 病因
Keywords:
Key words Small bowel obstruction; Imaging diagnosis; Multi-slice spiral CT; CTangiography; Site; Degree; Etiology
分类号:
R737.31
文献标志码:
A
摘要:
摘 要 〖HT5K〗目的：探讨64排螺旋CT静脉血管造影（MSCTA）在小肠梗阻（SBO）发病部位、程度和病因诊断中的价值。方法：回顾性分析79例SBO患者MSCTA资料，并将分析结果与临床、组织病理和术后综合结果对比，计算MSCTA用于SBO诊断的准确率。结果：经MSCTA检查，SBO患者肠管增厚、扩张，增强后呈现不同程度强化，肠系膜发生扭转，且有漩涡征。肠壁CT值为（62.36±10.72）HU，同层腰大肌CT值为（54.11±9.45）HU，两处CT值比较差异具有统计学意义（P＜0.05）。经MSCTA检查梗阻位于回肠46例、空肠20例、十二指肠13例，诊断准确率分别为95.74%、89.47%、92.31%，总准确率为93.67%（Kappa=0.89）；完全性肠梗阻51例、不完全性28例，诊断准确率分别为96.15%、96.30%，总准确率为96.20%（Kappa=0.92）；肠粘连29例、炎症17例、肿瘤13例、腹外疝8例、肠扭转9例、肠系膜血管栓塞2例、胆石1例，其中肠粘连、肠扭转和胆石诊断准确率为100.00%，炎症为94.12%，肿瘤为92.31%、腹外疝为88.89%、肠系膜血管栓塞66.67%，准确率为94.94%（Kappa=0.93）。结论：使用MSETA进行肠梗阻检查，检查数据经多种图像后处理技术分析，可明显提高其对SBO发病部位、梗阻程度及发病原因的诊断准确性，在外科急诊中具有较高应用价值。
Abstract:
Abstract Objective: To investigate the value of 64-slice spiral CT venography (MSCTA) in the diagnosis, location and etiology of small bowel obstruction (SBO).Methods: The MSCTA data of 79 SBO patients admitted to Xijing Hospital was analyzed retrospectively,and the results was compared with clinical, histopathological or postoperative comprehensive results, the accuracy of MSCTA for SBO diagnosis was calculated.Results: After MSCTA examination, the intestinal tube of SBO patients was thickened and expanded, and after enhancement, it showed different degrees of enhancement, the mesentery was twisted, and there was a vortex sign.The CT value of the intestinal wall was (62.36±10.72) HU, and the CT value of the same layer of lumbar muscle was (54.11±9.45) HU. There was significant difference between the two CT values (P＜0.05).The MSCTA examination showed 46 cases of ileum, 20 cases of jejunum and 13 cases of duodenum,and the diagnostic accuracy was 95.74%, 89.47% and 92.31%, respectively,the total accuracy was 93.67% (Kappa=0.89); complete intestinal obstruction 51 cases, 28 cases of incompleteness, the diagnostic accuracy were 96.15%, 96.30%, the total accuracy was 96.20% (Kappa=0.92); 29 cases of intestinal adhesion, 17 cases of inflammation, 13 cases of tumor, 8 cases of abdominal hernia 9 cases of intestinal torsion, 2 cases of mesenteric vascular embolization, 1 case of gallstone, of which the diagnostic accuracy of intestinal adhesion, volvulus and gallstone was 100.00%, inflammation was 94.12%, tumor was 92.31%, abdominal hernia was 88.89%, mesenteric vessel embolization was 66.67%, and the accuracy rate was 94.94% (Kappa=0.93).Conclusion:MSETA is used for intestinal obstruction examination. The data of the examination is analyzed by various image post-processing techniques, which can significantly improve the diagnostic accuracy of SBO, the degree of obstruction and the cause of the disease. It has high application value in surgical emergency.

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备注/Memo

备注/Memo:
*陕西省科学技术研究发展计划项目（2017K1402）
更新日期/Last Update: 2019-06-20