128层螺旋CT放射诊断对肠梗阻的发病部位、梗阻病因的诊断价值

The diagnostic value of 128-slice spiral CT in the diagnosis of the location of intestinal obstruction and the etiology of obstruction

目的探讨肠梗阻放射诊断中应用128层螺旋CT(Multislice Spiral CT,MSCT)、X线对梗阻部位、梗阻病因的诊断准确性及诊断效能。方法回顾性分析2018年1月—2019年5月在本院就诊的93例肠梗阻患者放射科临床资料,所有患者均接受X线、MSCT扫描检查。以手术结果检查结果作为金标准,对比两种放射诊断方式诊断肠梗阻部位、梗阻病因准确性,建立接受者操作特征(Receiver operating characteristic,ROC)曲线,计算两种诊断方式的ROC曲线下面积(Area Under Curve,AUC),分析X线、MSCT在肠梗阻中的诊断价值。结果腹部X线平片对梗阻部位诊断总准确性(93.55%)明显低于MSCT诊断肠梗阻部位总准确性(100.00%),差异具有统计学意义(P<0.05);腹部X线平片对梗阻病因诊断总准确性(72.04%)明显低于MSCT诊断肠梗阻病因总准确性(88.17%),差异具有统计学意义(P<0.05);ROC曲线结果显示,腹部X线平片诊断肠梗阻灵敏度为78.13%、特异度为70.15%、AUC为0.720;MSCT诊断诊断肠梗阻的灵敏度为88.24%、特异度为74.28%、AUC为0.882;表明MSCT诊断效能明显高于腹部X线平片。结论相较于腹部X线平片,MSCT对肠梗阻具有更高的诊断效能,灵敏度及特异度较高,且诊断发病部位及梗阻病因准确性更高,值得临床推广应用。

Objective To explore the diagnostic accuracy and diagnostic efficiency of 128-slice Spiral CT(MSCT)and X-rays diagnosing the location of obstruction and the cause of intestinal obstruction.Methods A retrospective analysis of the radiology clinical data of 93 patients with intestinal obstruction those ever got treatment in our hospital was carried out.All the patients received the detection of both X-ray and MSCT scanning.Set the pathology results as the gold standard,we compared the accuracy of the two methods in locating the obstruction and exploring the cause of the obstruction.The receiver operating characteristic(ROC)curve was established to calculates the area under the ROC curve(AUC)of the two diagnosis methods,and was used to analyze the diagnostic value of X-ray and MSCT in diagnosing intestinal obstruction.Results The total accuracy(93.55%)of the abdominal X-ray plain film in the diagnosis of the obstruction site was significantly lower than the total accuracy of the MSCT in the diagnosis of the intestinal obstruction site(100.00%)(χ^(2)=6.200,P<0.05).The total accuracy(72.04%)of abdominal X-ray plain film in diagnosing the cause of obstruction was significantly lower than that of MSCT(88.17%)(χ^(2)=7.591,P<0.05).The ROC curve results showed that the sensitivity of plain abdominal X-ray films for the diagnosis of intestinal obstruction was 78.13%,the specificity was 70.15%,and the AUC was 0.720;the sensitivity of MSCT in the diagnosis of intestinal obstruction was 88.24%,the specificity was 74.28%,and the AUC was 0.882.The diagnostic efficiency of MSCT was significantly higher than that of plain abdominal X-ray films.Conclusions Compared with plain abdominal X-ray films,MSCT has higher diagnostic efficiency for intestinal obstruction,performs higher sensitivity and specificity,and higher accuracy in diagnosing the location of the disease and the cause of the obstruction.It is worthy of clinical application.