MSCT及多平面重组技术在肠梗阻病因诊断中的应用价值

The application value of multi-slice spiral CT thin-layer and multiplanar reformation technique in the cause of intestinal obstruction

目的:探讨多层螺旋CT(MSCT)薄层扫描及计算机后处理技术在确定肠梗阻病因中的临床应用价值。方法:回顾性分析肠梗阻108例,其中经手术后病理证实102例,肠镜活检证实6例。患者均采用64层GE light speed VCT机行三期动态增强扫描,将薄层容积扫描数据,在工作站进行后重建处理,获得兴趣区的MPR图像、曲面重组(CPR)图像、滑动薄层块最大密度投影(STS-MIP)图像。对肠梗阻的梗阻病因作出诊断,然后与手术及肠镜结果进行逐一对照。结果:MSCT及多平面重组技术对肠梗阻总的病因诊断符合率为90.7%。肠道本身病变39例,诊断符合数34例(87.2%);肠道外病变50例,诊断符合数46例(92%);肠道内病变19例,诊断符合数18例(94.7%),以上三种分类病因的诊断符合率之间存在显著差异(2=8.79,P<0.05)。结论:MSCT及计算机后处理技术在确定肠梗阻病因中具有较高的诊断价值,可以作为肠梗阻患者的首选检查技术。

Objective：To evaluate the application value of multi-lice spiral CT （MSCT） thin-layer and image post-processing in the cause of intestinal obstruction. Methods： 108 patients of intestinal obstruction were scanned with GE 64-MSCT, followed with image post-processing techniques. Contrast medium was injected into veins in order to gain dynamic con- trast-enhanced image. Data were transferred to workstation to reconstruct, including multi-planar reconstruction （MPR）, curved planar reformations （CPR）, and volume rending （VR）. The causes of intestinal obstruction were diagnosed, MSCT findings were compared with pathology of surgery or colonoscopy to evaluate the MSCT and MPR of diagnostic value. Results： The agreement rate of etiological diagnosis with MSCT and image post-processing in intestinal obstruction was 90.7 %. In detail, the agreement rate of intrinsic lesions, intraluminal lesions, extrinsic lesions were 92.0 %, 94.7 % and 87.2%, respectively （significant difference,x2 =8.79, P 〈0.05）. Conclusion： It has high diagnostic value with MSCT and image post-processing techniques in etiological of intestinal obstruction, which can be used as the first choice for patients with intestinal obstruction examination.