多层螺旋CT诊断肠梗阻的临床价值

The diagnosis value of intestinal obstruction by Multislice computed tomography

目的探讨多层螺旋CT（MSCT）对急性肠梗阻的诊断价值。方法对50例临床疑似肠梗阻的患者，应用多层螺旋cT扫描，并将其诊断结果与手术、病理进行对照。结果MSCT诊断肠梗阻存在的正确率96％（48／50）、敏感性95％（41／43）、特异性92％（46／50）；X线立卧位平片诊断有无肠梗阻存在的正确率66％（33／50），敏感性76％（33／43）、特异性68％（34／50）；经手术或随访证实的17例cT检查病因诊断正确率82％（14／17）、定位诊断正确88％（15／17）；小肠手术诊断与cT的符合率无显著性差异（χ2=2．78，P〉0．05），结肠手术诊断与cT的符合率有显著性差异（χ2=23．95，P〈0．05）。结论多层螺旋cT扫描多平面重建成像能更清晰地显示急性肠梗阻病变，提高了cT对急性肠梗阻病因的诊断能力。

Objective To evaluate the role of Muhislice computed tomography（MSCT） in the diagnosis of a- cute ileus. Methods 50 cases with suspected of intestinal obstruction were scanned using MSCT. The diagnostic results of MSCT were compared with operation and pathology. Results The existence of ileus was diagnosed in 96% （48 of 50 cases） on MSCT scans, the sensitivity was 95 % （41 of 43 cases）, the specificity was 92% （46 of 50 cases）. The accurate rate of X-Ray plain film in the diagnosis of ileus in this study was 66% （33 of 50 cases） ,the sensitivity was 76% （33 of 43 cases） ,the specificity was 68% （34 of 50 cases）. The accuracy of etiological diagnosis of ileus made by MSCT in 17 cases proved by operation or clinical follow-up was 82% （ 14 of 17 cases） ,and the accuracy of location was 88% （ 15 of 17cases）. The rate of diagnosis accord of CT and surgery in intestinal were no significant difference（ χ2 = 2. 78 ,P 〉 0. 05 ） ;The rate of in line with diagnosis of CT and surgery in intestinal were no significant difference; The rate of in line with diagnosis of CT and surgery in colon were significant （ χ2 = 23.95, P 〈 0. 05 ）. Con- clusion Intestinal obstruction is more clearly revealed by MPR of MSCT, which improves the diagnostic ability of acute intestinal obstruction.