MRI在肠道急腹症诊断的临床应用价值

Clinical Application Value of MRI in Diagnosis of Acute Abdominal Disease

目的探讨MRI在诊断肠道急腹症中的应用价值。方法回顾性分析40例肠道急腹症患者的MRI表现,所有病例均经手术、病理或临床证实。结果恶性病变19例,17例伴肠梗阻:原发肠癌伴梗阻9例,腹膜转移粘连伴梗阻5例,肠淋巴瘤伴梗阻2例,肠间质瘤伴梗阻1例;另直肠癌伴穿孔、感染和乙状结肠癌伴周围感染各1例。良性病变21例,12例伴肠梗阻:单纯粘连性肠梗阻7例,其他原因所致梗阻5例;另肠穿孔伴周围感染3例,肠系膜血管病变2例,回盲部结核、回盲部感染伴脓肿、腹壁疝、肠系膜粘连扭转各1例。本组病例MRI对肠道急腹症的定位诊断准确率达92.5%(37/40),定性诊断敏感性90.91%、特异性94.44%,病因诊断符合率82.5%(33/40)。结论 MRI对病变的发现与显示,及定位、定性、病因学诊断具有较高的准确性,能为临床治疗方案的选择提供重要信息,在诊断肠道急腹症方面有重要的价值。

Objective To explore the value of MRI in the diagnosis of acute abdominal disease. Methods The MRI findings of 40 patients with intestinal acute abdomen were analyzed retrospectively and all cases were confirmed by surgery, pathology or clinical diagnosis. Results There were 19 cases of malignant lesions in total, and 17 cases with intestinal obstruction, including primary colorectal cancer with obstruction in 9 cases, peritoneal metastases with obstruction in 5 cases, intestinal lymphoma with obstruction in 2 cases, intestinal stromal tumor with obstruction in 1 case; besides, rectal cancer with perforation, infection and sigmoid colon cancer with peripheral infection in 1 case. There were 21 cases of benign lesion in total, 12 cases with intestinal obstruction： 7 cases of simple adhesive intestinal obstruction, 5 cases of obstruction caused by other causes; the other 3 cases of intestinal perforation with peripheral infection, 2 cases of mesenteric angiopathy; besides, ileocecal tuberculosis, ileoceae infection with abscess, abdominal hernia and mesenteric adhesion torsion in 1 case. This group of patients with MRI on the diagnosis of intestinal acute abdomen. The localization accuracy rate was 92.5%（37/40）, the qualitative diagnostic sensitivity was 90.91% and specificity was 94.44%, and the diagnostic accuracy rate was 82.5% in this group of patients. Conclusion MRI has high accuracy for the discovery and display of the lesions, as well as the diagnosis of localization, qualitative and etiological diagnosis. It can provide important information for the selection of clinical treatment programs. It is of great value in the diagnosis of acute abdomen.