腹腔脏器穿孔螺旋CT的诊断价值

Value of Spiral CT in the Diagnosis of Viscera Perforation of the Abdomen

目的探讨螺旋CT在腹腔脏器穿孔的诊断价值。方法回顾性分析16例经手术病理证实腹腔脏器穿孔患者的螺旋CT表现。结果 16例患者中,胃穿孔6例,十二指肠穿孔1例,末端回肠伴结肠穿孔1例,结肠穿孔1例,子宫穿孔1例,阑尾穿孔6例。螺旋CT表现为腹腔内游离气体、腹腔积液、肠系膜水肿、大网膜渗出、穿孔部位局限性肠壁增厚伴积气和周围脂肪间隙模糊。16例中,CT诊断为腹腔脏器穿孔13例(81.3%),对穿孔部位的诊断符合率为62.5%(10/16)。结论螺旋CT能显示腹腔脏器穿孔的主要征象,对部分患者的穿孔部位有提示性诊断价值,对手术有指导意义。

Objective To analyze the value of spiral computed tomorgraphy（CT）in diagnose of viscera perforation.Methods The review analysis 16 examples after the surgery confirmed that perforated patient＇s spiral CT findings for viscera. Results Of 16 example patients,6 were in the stomach,1 was in the duodenum,1 was in the terminal ileum accompany the colon,1 was in the colon ,1 was in the uterus, and 6 was in the appendicitis. The findings of spiral CT showed celiac free gas, free effusion, mesentery edema, omentum exudate, intestines wall thickening accompany pneumatosis around perforation spot and the surroundings dirty fat.The sensitivity of perforation by CT was 81.3%（13/16）,accurate judgement for perforated site was 62.5%（10/16）. Conclusion Spiral CT can display the main signs of viscera perforation,It also can give a indicative diagnosis of the perforative location in part of the patients and has the guiding significance for the surgery.