多层螺旋CT辅助多平面重建技术在疝补片修补术后并发感染诊断中的应用

Multiplanar reconstruction technique of multi-slice spiral CT in diagnosis of mesh infection following abdominal wall hernia repair

目的探讨多层螺旋CT辅助多平面重建技术在疝补片修补术后并发感染诊断中的应用。方法对2013年1月至2014年10月首都医科大学附属北京朝阳医院,因腹壁疝补片修补术后补片区域出现不适就诊患者82例,行多层螺旋CT检查,并进行薄层重建及多平面重建观察;测量补片周围渗出及软组织异常的范围,测量渗出的CT值。结果 82例患者中,多层螺旋CT图像出现补片周围感染征象72例(87.8%);72例出现补片周围感染征象患者中,31例经多层螺旋CT检查考虑合并补片感染;31例患者中29例经手术证实为补片感染,诊断符合率93.5%;补片感染患者腹壁疝补片周围区域积液CT值高于排除补片感染患者,差异有统计学意义。结论多层螺旋CT辅助多平面重建技术,有助于评价疝补片修补术后补片周围感染的范围以及组织结构受累的程度,有助于下一步治疗方案的选择。

Objective To investigate multi-slice spiral CT（ MSCT） with multiplanar reconstruction（ MPR） technique in diagnosis of mesh infection after hernia repair. Methods During January 2013 to January 2015,82 patients who complained about discomfort at mesh area,were admitted to Beijing Chaoyang Hospital and underwent multi-slice spiral CT scan; they were applied thin-section reconstruction and multiplanar reconstruction; we measured the range of exudation and soft tissue abnormalities around mesh and measured CT value of the exudation. Results After MSCT scan,72 cases（ 87. 8%） showed mesh peripheral infection signs; and 31 of them were diagnosed as mesh infection by MSCT; in these 31 patients,29 cases of mesh infection were confirmed by operations; the diagnosic accordance rate was 93. 5%. Patients with mesh infection had higher effusion CT value at mesh peripheral area than the other patients who had excluded mesh infection,the difference was statistically significant. Conclusion Multi-slice spiral CT with multiplanar reconstruction technique can help to evaluate the extent of mesh infection and infected tissue after abdominal wall hernia repair; And contribute to following treatment scheme.