MSCT对闭孔疝的术前早期诊断价值

目的确定多层螺旋CT(multislicle computed tomography,MSCT)对闭孔疝的术前早期诊断价值。方法收集经手术病理证实的闭孔疝16例,并根据手术结果分为坏死组(n=10)和无坏死组(n=6),对其术前CT表现和术中所见做对比分析。结果肠管呈"鸟嘴样"自闭孔沟疝入闭膜管,疝侧耻骨肌和闭孔外肌之间有疝囊显示为闭孔疝的特征性CT表现(16/16,100%)。嵌顿肠壁增厚、腹水、肠系膜水肿(P<0.05),提示嵌顿肠壁缺血,发生绞窄及坏死的概率较高。结论 MSCT能明确显示闭孔疝的直接征象,显著提高术前诊断准确率,有利于闭孔疝的早期诊断和手术治疗。

Objective To determine the role of MSCT for early preoperative diagnosis of obturator hernia OH.Methods 16 cases of OH were confirmed by surgery and pathology,the preoperative imaging and operative findings of all patients were retrospectively analyzed by divided into two groups necrosis group（n=10）non-necrosisgroup,（n=6）.Results The bowel herniated into obturator canal by pass through the obturator groove as a beak,and hernia sac between lateral obturator muscle and pectineus muscle were the characteristic sign of OH,and with the preoperative diagnosis accuracy of 100% by MSCT（16/16,100%）.Bowel wall thickening ascites and mesenteric edema with significant difference and may suggest ischemia with a high risk of strangulation and necrosis.Conclusion MSCT can clearly demonstrate the characteristic sign of OH,improve the preoperative diagnostic accuracy,and conducive to the early diagnosis and surgery.