CAJ | 학술논문

目的探讨经肛门泛影葡胺灌肠后行多层螺旋CT扫描检查诊断结直肠阴道瘘的价值.方法本组11例病例中,5例为阴道残端乙状结肠瘘,4例为阴道残端直肠瘘,2例为直肠阴道瘘,均经手术证实.所有病例均行泛影葡胺灌肠检查及盆腔多层螺旋CT检查；将0.625 mm层厚和层间距图像传至工作站进行图像后处理,利用后处理软件获取盆腔结直肠阴道瘘的三维重建图像.结果通过CT重建图像发现,乙状结肠阴道瘘5例,直肠阴道瘘6例；其中4例在盆腔内可见“湖状”造影剂积聚.多平面重组图能够清楚显示对比剂在直肠、乙状结肠、阴道内存留,以及对比剂在盆腔内团状积聚,还可清楚显示瘘口的位置、大小和对比剂在肠管内、阴道内的走行方向.结论泛影葡胺对比剂灌肠后行多层螺旋CT检查,可极大提高结直肠阴道瘘检查的准确性,为临床手术方案的制定提供准确的诊断依据.
목적 탐토경항문범영포알관장후행다층라선CT소묘검사진단결직장음도루적개치.방법 본조11례병례중,5례위음도잔단을상결장루,4례위음도잔단직장루,2례위직장음도루,균경수술증실.소유병례균행범영포알관장검사급분강다층라선CT검사；장0.625 mm층후화층간거도상전지공작참진행도상후처리,이용후처리연건획취분강결직장음도루적삼유중건도상.결과 통과CT중건도상발현,을상결장음도루5례,직장음도루6례；기중4례재분강내가견“호상”조영제적취.다평면중조도능구청초현시대비제재직장、을상결장、음도내존류,이급대비제재분강내단상적취,환가청초현시루구적위치、대소화대비제재장관내、음도내적주행방향.결론 범영포알대비제관장후행다층라선CT검사,가겁대제고결직장음도루검사적준학성,위림상수술방안적제정제공준학적진단의거.
Objective To explore the value of multi-slice spiral CT scaning with anal diatrizoate meghmine enema in the diagnosis of colorectal vaginal fistula.Methods Of 11 patients with pathologically confirmed fistula,5 had fistula of sigmoid colon and vaginal stump,4 had vaginal stump fistula,and 2 had rectovaginal fistula.All the patients underwent diatrizoate enema and pelvic multi-slice CT scanning.The images with layer thickness of 0.625 mm were transmitted to the workstation; the post-processing software was used to obtain three-dimensional reconstruction images of pelvic colorectal vaginal fistula.Results Sigmoid-vaginal fistula was found in 5 patients,and rectovaginal fistula in 6; 4 of which had lake-shaped accumulation of contrast agent on the pelvic CT images.The multi-planar reconstruction image clearly showed the contrast agent stayed in the rectum,sigmoid colon,and vagina,a mass accumulation of contrast agent in the pelvic cavity,location of the fistula,and moving direction of contrast agent within the bowel and vagina.Conclusions Multi-slice CT scanning with diatrizoate enema contrast greatly improve the diagnostic accuracy of the colorectal vaginal fistula and provide an accurate support for the development of clinical surgery scheme.