MSCTE和MSCTA联合运用在小肠梗阻病因诊断中的价值

Value of MSCTA and MSCTE in etiological diagnosis of small bowel obstruction

目的探讨多层CT小肠造影(MSCTE)和多层CT血管造影(MSCTA)联合运用在小肠梗阻病因诊断中的价值。方法回顾性分析57例行MSCTE和MSCTA检查,并经过手术和病理检查证实为小肠梗阻患者的影像学资料。使用Siemens Somatom Sensation 64层螺旋CT进行检查,经过后处理方法[多平面重建(MPR)、最大密度投影(MIP)、容积再现技术(VRT)、曲面重建法(CPR)],分析其图像在小肠梗阻病因诊断中的作用。结果所有病例中,肿瘤15例,粘连14例,腹外疝8例,炎症6例,内疝或扭转5例,肠套叠3例,胆石或粪石4例,血管性2例。组Ⅰ:常规横断位结合MPR、CPR对病因诊断的准确性为89.5%(51/57);组Ⅱ:常规横断位结合MPR、CPR和CTA技术(VRT、MIP)对病因诊断的准确性为94.7%(54/57);组Ⅱ的诊断准确性明显高于组Ⅰ(P<0.05)。结论 MSCTA和MSCTE的联合运用可以明显提高小肠梗阻病因诊断的准确性,具有较高的临床应用价值。

Objective To study the value of MSCTE and MSCTA in etiological diagnosis of small bowel obstruction（SBO）.Methods Retrospective analysis was made on 57 patients admitted to our hospital diagnosed as SBO by surgery,pathology or DSA,and all had unabridged MSCTE and MSCTA materials at the same examination.Each CT imaging of patients with SBO was analyzed at diagnosis site by using post processing such as MPR,MIP,VRT and CPR on Siemens Somatom Sensation 64-slice spiral CT.Results Among the 57 patients with SBO,there were 15 cases caused by tumor,14 by adhesions,8 by extra-abdominal hernia,6 by inflammation,5 by internal hernia or volvulus,3 by intussusception,4 by gallstones or fecalith,2 by embolism of mesenteria blood vessels.The accuracy rate was 89.5% in group Ⅰ with studying images of axial view combined,MPR and CPR,and 94.7% in group Ⅱ with studying images of axial view,combined MPR,CPR,VRT and MIP.There was notable difference at the accuracy of etiological diagnosis between group Ⅰ and group Ⅱ（P0.05）.Conclusion The combined application of MSCTE and MSCTA is useful to improve the accuracy of etiological diagnosis for SBO,which has important value in clinical application.