CT平扫及增强检查对于脾栓塞手术效果的评价

Application of Plain CT Scan and Enhanced CT Scan in Evaluation of the Effects of Splenic Embolization Surgeries

目的探讨CT平扫及增强检查在脾栓塞手术中的应用以及术后不同时期脾脏的CT表现特点。方法 2012年1月~2015年1月,我院行脾栓塞术者52例,所有患者在术后1周、1月、3月及6月复查上腹部CT平扫以及增强。并根据术后1周的CT图像测量脾脏栓塞区与非栓塞区体积,计算出每一位患者脾脏栓塞比例,再根据栓塞比例的不同,将本组病例分为Ⅰ、Ⅱ两组。Ⅰ组栓塞比例≤50%,Ⅱ组栓塞比例〉50%,并通过CT图像分析栓塞脾组织在各个观察时间点的变化。结果术后1月行CT检查可见Ⅰ组患者中27例出现部分修复,而Ⅱ组中仅5例患者出现部分修复,比较差异有统计学意义（P〈0.05）。Ⅰ组中0例患者出现梗死伴液化,Ⅱ中6例患者出现梗死伴液化,比较差异有统计学意义（P〈0.05）。术后3月行CT检查可见I组患者中17例出现部分修复,15例完全修复。而Ⅱ组中8例患者出现部分修复,4例患者完全修复。部分修复比较差异无统计学意义（P〉0.05）,完全修复比较差异有统计学意义（P〈0.05）。Ⅰ组中0例患者出现梗死伴液化,Ⅱ组中11例患者出现梗死伴液化,比较差异有统计学意义（P〈0.05）。术后6月行CT检查可见Ⅰ组患者都完全修复。而Ⅱ组中12名患者完全修复,比较差异有统计学意义（P〈0.05）。结论脾栓塞术后脾脏会经历一系列的病理生理变化,而CT平扫以及增强检查可以在各个时期提供分辨率高、清晰的图像,因此CT检查在脾栓塞术中应用价值高,并且有微创、时间短等优点。

Objective To investigate the application of plain CT scan and enhanced CT scan in splenic embolization surgeries and postoperative splenic CT imaging features in different periods. Methods Altogether 52 cases of splenic embolization treated in the hospital from January 2012 to January 2015 were involved as the objects of research and underwent epigastric plain CT scanning and enhanced CT reexaminations at postoperative 1 week, 1 month, 3 months and 6 months. And according to the CT images at postoperative 1 week, the area of splenic embolization and non-embolization were measured so as to calculate the proportion of splenic embolism in each patient; then, based on the different embolism proportions, all the patients were divided into Group Ⅰ（Embolization Percentage ≤50%） and Group Ⅱ（Embolization Percentage 50%）. The analysis of the changes in CT images of splenic embolization tissue at each observation point was made. Results According to the CT examinations at postoperative 1 month, partial repair was revealed in 27 cases among Group Ⅰ patients versus 5 cases in Group Ⅱ, with statistically significant difference（P〈0.05）; 0 patient in Group Ⅰ was found with infarctions with liquefaction in contrast with 6 patients in Group Ⅱ, with statistically significant difference（P〈0.05）. CT examinations at postoperative 3 month revealed 17 cases of partial repair and 15 cases of full repair in Group Ⅰ versus 8 cases of partial repair without statistically significant difference（P〈0.05）, 4 cases of full repair with statistically significant difference（P〈0.05）, in Group Ⅱ as well as 0 case of infarctions with liquefaction in Group Ⅰ in contrast with 11 patients in Group Ⅱ, with statistically significant difference（P〈0.05）. As for the results of CT examinations at postoperative 6 months, all the patients in Group Ⅰ were fully repaired compared with 12 cases in Group Ⅱ, with statistically significant difference（P〈0.05）. Conclusion The patients＇ spleen would go through a series of pathophysiological changes postoperatively. CT scanning and enhanced CT examinations could provide high-resolution and clear images during various periods. And the CT examination also proved its advantages of minimal invasion and short duration of surgery and great effectiveness in the splenic embolization surgeries.