MSCT多平面及曲面重组对小肠梗阻的定位诊断与评价研究

Location Diagnosis of Small Bowel Obstruction Using MSCT with Multi-planar and Curved Planar Reformation

目的评价MSCT多平面重组（multiplanar reformations,MPR）结合曲面重组（curved planar reformations,CPR）在机械性小肠梗阻定位诊断中的价值。资料与方法选择120例临床怀疑小肠梗阻患者行64层MSCT扫描,其中72例存在小肠梗阻,48例无小肠梗阻。由两名经验丰富的腹部放射学医师分别独立解释单纯横断位、横断位＋冠状位和MPR＋CPR图像,确定梗阻点或移行带,诊断可靠性按照1~3级予以评分。结果两名医师采用不同重组影像进行小肠梗阻定位的准确性分别为：单纯横轴位79%和78%,横轴位＋冠状位90%和92%,MPR＋CPR97%和99%。MPR＋CPR与单纯横轴位的定位准确性比较差异有统计学意义（P〈0.01）。不同重组影像的平均可信度积分分别为：单纯横轴位2.181和2.139,横轴位＋冠状位2.486和2.569,MPR＋CPR2.931和2.959。MPR＋CPR的可信度积分较单纯横轴位和横轴位＋冠状位均有显著提高（P〈0.01）。结论 MPR结合CPR对小肠梗阻的定位诊断更加准确可靠,可作为小肠梗阻MSCT检查的常规后处理技术。

Objective To evaluate the value of multi slice spiral CT（MSCT）with multi-planar reformation（MPR）and curved planar reformations（CPR）in the location diagnosis of mechanical small bowel obstruction（SBO）.Materials and Methods One hundred and twenty consecutive patients suspected of SBO underwent 64-slice MSCT scan and 72 patients were finally diagnosed with SBO.Two radiologists independently evaluated the obstruct site and transition zone on transverse images,transverse＋coronal images,and MPR＋CPR images.Confidence was graded with 1-3 score.Results For the two radiologists,the accuracy of obstruct site were 79% and 78%,90% and 92%,and 97% and 99% on transverse images,transverse＋coronal images,and MPR＋ CPR images,respectively.The accuracy of MPR＋CPR imagess was significantly higher than that of transverse images alone（P0.01）.The mean confidence score of transverse images,transverse＋coronal images,and MPR＋CPR views were 2.181 and 2.139,2.486 and 2.569,and 2.931 and 2.959,respectively.Mean confidence score of MPR＋CPR imagess was significantly higher than that of transverse images alone and transverse＋coronal images（P0.01）.Conclusion MPR combined with CPR can increase both accuracy and confidence in the location diagnosis of SBO and,therefore,might serve as conventional post-processing techniques for SBO.