螺旋CT三维重建技术在腹壁疝中的应用

Multi-slice CT three-dimensional reconstruction techniques in abdominal wall hernia

目的:探讨多层螺旋CT三维重建技术及腹腔容积测量在腹壁切口疝术前的临床应用价值。方法:通过对28例临床确诊腹壁切口疝患者行多层螺旋CT扫描并行腹腔容积及疝体积测量,以疝体积/腹腔容积超过20%作为不直接手术的指标。并且对腹腔容积和体质量指数(BMI)进行相关性分析。结果:28例患者均完成腹腔容积及疝体积的测量,其中1例患者疝囊/腹腔容积大于20%而未推荐行腹腔镜疝修补术,体质量指数(BMI)与腹腔容积的相关分析指数0.672。结论:多层螺旋CT三维重建技术可以获得腹壁疝患者的腹腔容积及疝体积数据,并通过两者比值决定是否直接行疝修补手术,为复杂切口疝的治疗和分类提供一种新的思路。

Objective：To investigate the clinical value of multi-slice CT three-dimensional reconstruction techniques and abdominal incisional hernia volume measurement in the diagnosis and treatment of incisional hernia.Methods：The abdominal wall defect and abdominal cavity volume were measured based on spiral CT scan and the three-dimensional recon-struction techniques on workstation （GE 4.3）were performed in 28 patients who were clinically diagnosed as incisional hernia.The size of the surgical patch was determined.The hernia volume/volume of abdominal cavity volume more than 20%was regarded as not surgical indication.The correlation of abdominal cavity volume and patients body mass index （BMI） was also analyzed.Results：For all 28 patients,the hernia volume and abdominal cavity volume were measured.In one of the 28 cases,the hernia volume/abdominal cavity volume was more than 20%,and therefore the laparoscopic hernia repair was not recommended.The relative index between body mass index （BMI）and abdominal cavity volume was 0.672.Conclusion：Multislice spiral CT 3D reconstruction technique can measure abdominal wall hernia volume and abdominal cavity volume as well as the size of hernia orifice,and accurately display the contents of the hernia sac,and provide more accurate preoperative informations for determintion of patch and the way of operation.Especially it provides a new way of thinking for classification and treatment in complex incisional hernia.