放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2014年
11期
1297-1299
,共3页
茅旭平%陆建东%许冰弦%陈晓宇%张志国
茅旭平%陸建東%許冰絃%陳曉宇%張誌國
모욱평%륙건동%허빙현%진효우%장지국
消化道穿孔%游离气体%门静脉%体层摄影术,X线计算机
消化道穿孔%遊離氣體%門靜脈%體層攝影術,X線計算機
소화도천공%유리기체%문정맥%체층섭영술,X선계산궤
Gastrointestinal perforation%Free air%Portal vein%Tomography,X-ray computed
目的：评价CT对上消化道与下消化道穿孔的鉴别诊断价值。方法：回顾性分析64例消化道穿孔患者的CT图像，评价游离气体的位置、门静脉周围游离气体征、镰状韧带征和肝圆韧带征与消化道穿孔位置的关系。结果：上消化道穿孔的游离气体位于结肠下区的概率（7／42，16．7％）显著低于下消化道穿孔（18／22，81．8％），而上消化道与下消化道穿孔的游离气体出现在结肠上区的概率差异无统计学意义（P＝0．25）。门静脉周围游离气体征出现在上消化道穿孔的概率（27／42，64．3％）显著高于下消化道穿孔（8／22，36．4％，P＝0．03），而镰状韧带征和肝圆韧带征出现在上消化道和下消化道穿孔患者中的概率差异无统计学意义（P＞0．05）。结论：CT 显示游离气体的位置对鉴别消化道穿孔位置有重要价值，门静脉周围游离气体征提示消化道穿孔位于上消化道，结肠下区游离气体提示穿孔位于下消化道。
目的：評價CT對上消化道與下消化道穿孔的鑒彆診斷價值。方法：迴顧性分析64例消化道穿孔患者的CT圖像，評價遊離氣體的位置、門靜脈週圍遊離氣體徵、鐮狀韌帶徵和肝圓韌帶徵與消化道穿孔位置的關繫。結果：上消化道穿孔的遊離氣體位于結腸下區的概率（7／42，16．7％）顯著低于下消化道穿孔（18／22，81．8％），而上消化道與下消化道穿孔的遊離氣體齣現在結腸上區的概率差異無統計學意義（P＝0．25）。門靜脈週圍遊離氣體徵齣現在上消化道穿孔的概率（27／42，64．3％）顯著高于下消化道穿孔（8／22，36．4％，P＝0．03），而鐮狀韌帶徵和肝圓韌帶徵齣現在上消化道和下消化道穿孔患者中的概率差異無統計學意義（P＞0．05）。結論：CT 顯示遊離氣體的位置對鑒彆消化道穿孔位置有重要價值，門靜脈週圍遊離氣體徵提示消化道穿孔位于上消化道，結腸下區遊離氣體提示穿孔位于下消化道。
목적：평개CT대상소화도여하소화도천공적감별진단개치。방법：회고성분석64례소화도천공환자적CT도상，평개유리기체적위치、문정맥주위유리기체정、렴상인대정화간원인대정여소화도천공위치적관계。결과：상소화도천공적유리기체위우결장하구적개솔（7／42，16．7％）현저저우하소화도천공（18／22，81．8％），이상소화도여하소화도천공적유리기체출현재결장상구적개솔차이무통계학의의（P＝0．25）。문정맥주위유리기체정출현재상소화도천공적개솔（27／42，64．3％）현저고우하소화도천공（8／22，36．4％，P＝0．03），이렴상인대정화간원인대정출현재상소화도화하소화도천공환자중적개솔차이무통계학의의（P＞0．05）。결론：CT 현시유리기체적위치대감별소화도천공위치유중요개치，문정맥주위유리기체정제시소화도천공위우상소화도，결장하구유리기체제시천공위우하소화도。
Objective:To assess the value of computed tomography (CT)in the differential diagnosis of upper and lower gastrointestinal (GI)tract perforation.Methods:Abdominal CT images of 64 patients with surgically proven GI tract perforation were analyzed retrospectively.The distribution of free air,periportal free air (PPFA)sign,falciform ligament sign and the ligamentum teres sign were evaluated and compared between upper and lower GI tract perforation.Results:Free air was seen in inframesocolic compartment in 7 of 42 (16.7%)patients in the upper GI perforation group and in 18 of 22 (81 .8%)patients in the lower GI perforation group.Free air in supramesocolic compartment did not show significant differ-ence in either group (P= 0.25).The incidence rate of the PPFA sign in upper GI tract perforation patients (64.3%)was higher than that in the lower GI tract perforation patients (36.4%,P= 0.03).The incidence rates of the falciform ligament sign and the ligamentum teres sign were not significantly different between the upper and lower GI tract perforation group. Conclusion:The distribution of free air on CT is useful in the differential diagnosis of upper and lower gastrointestinal (GI) tract perforation.PPFA sign is suggestive of upper GI tract perforation while free air in inframesocolic compartment is sug-gestive of lower GI tract perforation.
