多层螺旋CT扫描与图像后处理在腹股沟疝术前分型的评估效能

Efficiency analysis of multi-slice spiral CT scanning and image post-processing in preoperative classification of groin hernia patients

目的探讨分析多层螺旋计算机断层扫描(MSCT)与图像后处理在腹股沟疝术前分型评估中的效能。方法回顾性分析2015年1月至2019年8月,徐州市中医院采用腹腔镜经腹腹膜前疝修补术(TAPP)治疗的腹股沟疝86例患者的临床资料,术前均采用MSCT与图像后处理检查,进行分型评估,统计不同分型患者的影像学表现特点及分型结果,并将腹腔镜术中所见分型作为标准,采用Kappa检验分析MSCT与图像后处理检查结果和腹腔镜术中所见结果的一致性。结果MSCT与图像后处理术前分型评估和腹腔镜术中分型结果:术前斜疝77例,Ⅰ型29例、Ⅱ型41例、Ⅲ型7例;术中Ⅰ型30例、Ⅱ型40例、Ⅲ型8例;术前直疝5例,Ⅳ型2例、Ⅴ型3例,术中Ⅳ型1例、Ⅴ型4例;术前马鞍疝Ⅵ型3例,术中Ⅵ型2例;术前股疝Ⅶ型1例,术中Ⅶ型1例。斜疝、直疝、马鞍疝和股疝患者MSCT与图像后处理术前分型结果与腹腔镜术中分型的符合率分别为93.48%、100%、79.43%、100%;MSCT与图像后处理腹股沟疝术前分型和腹腔镜术中分型一致性良好(Kappa=0.9106,P<0.05)。结论MSCT与图像后处理在腹股沟疝术前分型评估中效能高,与腔镜术中所见分型结果高度一致。

Objective To explore and analyze the efficacy of multi-slice spiral computed tomography(MSCT)scanning and image post-processing in preoperative classification of groin hernia patients.Methods The clinical data of 86 cases of adult groin hernia treated by laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)in Xuzhou Traditional Chinese Medicine Hospital from January 2015 to August 2019 were retrospectively analyzed.MSCT and image post-processing were used to evaluate the classification before operation.The imaging features and classification results of patients with different types were counted,and the classification seen in laparoscopy was regarded as the standard.Kappa test was used to analyze the consistency between MSCT and image post-processing examination results and intraoperative findings.Results The results of MSCT and image post-processing examination before typing were 77 cases of indirect groin hernia,typeⅠin 29 cases,typeⅡin 41 cases,typeⅢin 7 cases,the results of laparoscopic typing were:typeⅠin 30 cases,typeⅡin 40 cases,typeⅢin 8 cases;The results of MSCT and image post-processing examination before typing were 5 cases of direct groin hernia,typeⅣin 2 cases,typeⅤin 3 cases,the results of laparoscopic typing were:typeⅣin 1 case,typeⅤin 4 cases;The results of MSCT and image post-processing examination before typing were 3 cases of groin saddle hernia,typeⅥin 3 cases,the results of laparoscopic typing were:type VI in 2 cases;The results of MSCT and image post-processing examination before typing were 1 case of femoral hernia(typeⅦ),the results of laparoscopic typing were:typeⅦin 1 case.The coincidence rates of MSCT and image post-processing preoperative typing and laparoscopic typing were 93.48%,100%,79.43%,100%for indirect groin hernia,direct groin hernia,groin saddle hernia and femoral hernia,respectively.According to Kappa test,MSCT had good consistency with preoperative and laparoscopic classification of indirect groin hernia,direct groin hernia,groin saddle hernia and femoral hernia after image processing(Kappa=0.9106,P<0.05).Conclusion MSCT and image post-processing are highly effective in evaluating preoperative classification of groin hernia patients by laparoscopy,and are highly consistent with the results of intraoperative classification.