多层螺旋CT在腹股沟疝患者手术中的临床意义

Clinical value of multi-slice spiral CT in surgery for inguinal hernia

目的:探究多层螺旋CT(MSCT)对腹股沟疝患者手术的临床意义。方法:选取157例腹股沟疝患者为研究对象,依据检查方法不同分为MSCT组(n=78)和B超组(n=79)。MSCT组行MSCT扫描检查;B超组行B超检查。以术后病理结果为金标准,评估MSCT、B超对腹股沟疝分类和分型的诊断价值及MSCT各扫描序列对腹股沟疝疝囊颈与腹壁下动脉关系的诊断价值,分析MSCT检查腹股沟疝与腹股沟韧带的关系及典型病例的影像学图像。结果:以术后病理结果为金标准,MSCT组对腹股沟疝分类及Ⅰ~Ⅲ型的分型诊断的准确率高于B超组(P<0.05)。MSCT各序列扫描结果与术后病理结果对照发现,MSCT冠状位扫描诊断腹股沟疝准确率高于矢状位和横断位(P<0.05),冠状位MSCT扫描更利于准确辨别腹股沟疝疝囊与腹壁下动脉的关系(P<0.05)。MSCT检查显示,腹股沟斜疝、腹股沟直疝位于腹股沟疝韧带的前方,股疝位于腹股沟韧带的后方;腹股沟斜疝、腹股沟股疝均无侧新月征,腹股沟直疝有侧新月征,1例侧新月征显示不清。结论:MSCT对腹股沟疝分类和分型诊断的准确率高,同时可准确评估腹股沟疝疝囊颈与腹壁下动脉关系,利于术前明确腹股沟疝与腹股沟韧带的关系,对外科手术有指导意义。

Objective:To explore the clinical value of multi-slice spiral CT(MSCT)in surgery for inguinal hernia.Methods:157 patients with inguinal hernia were divided into MSCT group(n=78)and B-ultrasound group(n=79)according to the examination methods.With postoperative pathological results as the golden standard,the value of MSCT and B-ultrasound for inguinal hernia classification and typing was evaluated.The value of MSCT scan sequences in analyzing the relationship between the inguinal hernia sac neck and the inferior abdominal wall artery,the relationship between the inguinal hernia and the inguinal ligament displayed by MSCT were analyzed.Meanwhile,the images of typical cases were analyzed.Results:With postoperative pathological results as the golden standard,the accuracy and diagnostic accuracy rate of MSCT for typeⅠ-Ⅲin inguinal hernia classification were significantly higher than those of B-ultrasound(P<0.05).The comparison of MSCT sequence scan results with postoperative pathological results showed that the accuracy of MSCT coronary scan in the diagnosis of inguinal hernia was higher than that of sagittal or axial scan(P<0.05).Coronary MSCT scan was more conducive to the accurate diagnosis of the relationship between inguinal hernia sac and inferior abdominal wall artery(P<0.05).MSCT showed that the inguinal hernia and the straight inguinal hernia were located in front of the inguinal hernia ligament,while the femoral hernia was located behind the inguinal ligament.The inguinal hernia and inguinal hernia showed no lateral crescent sign,while the straight inguinal hernia had lateral crescent sign.1 case of lateral crescent sign was unclear.Conclusion:MSCT is highly accurate in the classification and typing of inguinal hernia.It can also accurately evaluate the relationship between the inguinal hernia sac neck and the inferior abdominal wall arteries,which is conducive to clarify the relationship between inguinal hernia and inguinal ligament before operation,and has guiding significance Clinical.