64层螺旋CT图像后处理技术在肠梗阻病因诊断中的价值

Post-processing technique of 64-slice spiral CT in the etiological diagnosis of intestinal obstruction

目的探讨64层螺旋CT图像后处理技术对于肠梗阻病因的诊断价值。方法 78例经手术或临床明确诊断的肠梗阻病例,行全腹部平扫及增强扫描,在工作站上采用多平面重组、MIP及VR方法进行图像后处理,观察肠梗阻的有无、部位、病因及有无合并肠缺血。结果对78例肠梗阻病因诊断结果中,CT诊断符合率分别为肠粘连78.26%(18/23),肿瘤94.12%(16/17),腹内、外疝75.00%(6/8),肠套叠83.33(5/6),炎症66.67%(4/6),肠腔内异物80.00%(4/5),肠扭转85.71%(6/7),外伤66..67%(2/3),血运性肠梗阻100%(3/3),CT对梗阻病因诊断总体敏感性87.18%(68/78),准确性82.05%(64/78),假阳性5.13%(4/78),假阴性17.95%(14/78)。结论 64层螺旋CT图像后处理技术在肠梗阻病因诊断中有很高的临床应用价值,可作为临床肠梗阻诊断的首选检查方法。

Objective To evaluate 64-slice spiral CT and post-processing techniques in diagnosis of the causes of intestinal obstruction（IO）.Methods 78 cases with intestinal obstruction confirmed by surgery or clinical diagnosis underwent plain and enhanced scanning of the entire abdomen.The multi-planar reformation（MPR） images of abdomen,maximum intensity projection（MIP） and volume rendering（VR） images of mesenteric vessels were reconstructed on workstation.The presence,location,etiology of intestinal obstruction and complicated ischemia of bowel were evaluated.Results The cuases of IO included adhesion 78.26%（18/23）,neoplasm94.12%（16/17）,external or internal hernia75.00%（6/8）,inflammatory disease66.67%（4/6）,bowel torsion85.71%（6/7）,enterolith80.00%（4/5）,intussusception83.33（5/6）,ischemia100%（3/3）,trauma66..67%（2/3）,Total sensitivity of etiology diagnosis with CT was 87.18%（68/78）,with accuracy,false positive and false negative to be 82.05%（64/78）,5.13%（4/78）,17.95%（14/78）respectively.Conclusion post-processing technique of 64-slice spiral CT is of significant clinical value in diagnosis of intestinal obstruction,which should be used as the first means in clinic practice.