多层螺旋CT在十二指肠溃疡分期诊断及中医症候分析中的应用价值

Effectiveness of Application of Plain MSCT Scan in Staging Diagnosis and Analysis of Different Traditional Chinese Medicine Syndrome Types of Duodenal Ulcer Perforation

目的探讨多层螺旋CT平扫结合多平面重建技术在不同中医症候分型十二指肠溃疡诊治中的应用价值。方法筛选2015年1月-2016年1月我院收治的经胃镜/胃肠双对比造影检查确诊十二指肠溃疡患者126例。所有患者均接受多层螺旋CT平扫及多平面重建技术,并根据患者病因病机对其进行中医症候分型,观察126例患者中医症候分布规律,并根据螺旋CT影像结果进行诊断,分析总结不同中医症候患者CT表现。结果根据患者病因病机及临床表现可将患者分为肝胃郁热型、肝胃不和型、脾胃虚寒型;根据螺旋CT影像结果确诊十二指肠溃疡119例,与临床证实结果具有较高的一致性,Kappa=0.753;CT检出结果与胃镜/胃肠双对比造影检查结果比较无显著差异（P〉0.05）;不同中医症候分型十二指肠溃疡患者螺旋CT影像表现比较存在显著差异。结论多层螺旋CT平扫及多平面重建技术诊断十二指肠溃疡准确率较高,并且对于不同中医症候分型具有较高的鉴别能力,具有临床应用及推广价值。

Objective To investigate the effectiveness of application of plain multi-slice spiral CT（MS CT） scan and the multi-planar reconstruction（MPR） technique in treatment and diagnosis of different TCM（Traditional Chinese Medicine） syndrome types of duodenal ulcer perforation. Methods Altogether 126 patients who were confirmed as duodenal ulcer perforation by gastroscopic/gastrointestinal double contrast examinations and treated in the hospital from January 2015 to January 2016 were selected as the research objects. All patients underwent plain MSCT scan and MPR, and were divided into TCM syndrome types according to the etiology and pathogenesis. The distribution rule of TCM syndromes in 126 patients was observed and all the patients were diagnosed according to the spiral CT imaging findings so as to analyze and summarize the CT imaging findings of different TCM syndromes. Results According to the etiology, pathogenesis and clinical manifestations, patients were divided into liver stomach heat type, blood deficiency type and blood stasis type; according to spiral CT imaging results, 119 patients were confirmed as duodenal ulcer perforation, consistent with clinical results, Kappa=0.753. In contrast with gastroscopic/gastrointestinal double contrast examinations, CT imaging findings showed no statistically significant difference,（P〉0.05）. The spiral CT images of patients with different TCM syndrome types of duodenal ulcer perforations showed statistically significant differences.（P〈0.05） Conclusion Combination of plain MSCT scan and MPR demonstrated high accurate rate in diagnosis of duodenal ulcer perforation and excellent effectiveness in differentiation of different TCM syndrome types, which was of great significance in wider clinical application and popularization.