膈疝的影像学特征及其诊断价值(附31例分析)

Diaphragmatic Hernia of Image Features and Its Diagnostic Values (Analyze of 31 Cases)

目的:分析膈疝的胸部平片、胃肠道钡餐造影及胸部CT影像学特征,探讨其诊断价值。材料与方法:对31例具有完整的临床、影像学、手术病理资料的膈疝病例进行全面的分析。结果:平片检查快速、简便,价格低廉,但诊断价值有限,正确率仅41.9%;钡餐造影明显优于平片,正确率77.4%,但对实质性脏器显示能力差,易致误诊;CT检查可清楚显示疝内容物及膈肌缺损部位及范围,但对滑动性疝易漏诊且不能反映胃肠道功能。结论:三种影像学检查方法分别有其特点,临床上应将三者有机结合,以充分提高膈疝诊断正确率,改善预后。

Purpose： To analyze the image features of chest X - ray film, gastrointestinal baxinm examination and chest CTandtoexplore their diagnostic value for diaphragmatic hernia （DH）. Materials and Methods： The imaging features of 31 patients with complete clinical, imaging and pathological materials were analysis in details before operation. Results： Chest X- ray film is rapid, simple and cheap, but its diagnostic value is limited, only with accurate rate 41.9%. Gastrointestinal barium examination is obviously better than that of chest X - ray film. with accurate rate 77.4 %. Misdiagnosis of DH is possible because it cannot clearly disphy parenchyma organ. CT can display clearly hernia contents and the defect position and scope of diaphragmatic muscle, but missed diagnosis is possible for glide hernia because it cannot reflect the functions of gastrointestinal tract. Conclusion： the three methods for DH diagnosis have specific value. Combining use of various imaging examination in clinic can sufficiently increase accurate rate and improve prognosis of DH.