放射学实践
放射學實踐
방사학실천
RADIOLOGIC PRACTICE
2015年
6期
655-659
,共5页
文峰%赵振国%顾强%夏郁金
文峰%趙振國%顧彊%夏鬱金
문봉%조진국%고강%하욱금
十二指肠%损伤%体层摄影术,X 线计算机%病理学
十二指腸%損傷%體層攝影術,X 線計算機%病理學
십이지장%손상%체층섭영술,X 선계산궤%병이학
Duodenum%Injuries%Tomography,X-ay computed%Pathology
目的：探讨十二指肠钝性损伤的 MSCT 诊断。方法：回顾性分析经手术或临床证实的36例十二指肠钝性损伤患者的 MSCT 表现。所有患者均行 MSCT 横断平扫，分别就平扫、平扫联合后处理图像两种方法对是否十二指肠钝性损伤进行双盲读片，两种方法对十二指肠钝性损伤的检出率运用配对四格表 McNemar 确切概率法χ2检验。结果：36例十二指肠钝性损伤分别位于十二指肠球部2例，降部18例，水平部3例，升部3例，降部和水平部交界区10例。十二指肠钝性损伤的 MSCT 主要表现为十二指肠肠壁增厚、十二指肠周围膜脂肪条索影、十二指肠肠壁血肿、腹膜后游离气体影、腹膜后积液和腹膜后血肿，其检出率分别为80．6％、91．7％、8．3％、13．8％、30．6％和16．7％。本组综合运用 MSCT 征象对十二指肠钝性损伤的正确诊断率达88．9％（32／36）。两种方法对十二指肠钝性损伤的检出率有显著性差异（P ＝0．031）。结论：十二指肠钝性损伤的 MSCT 表现具有一定特点，根据 MSCT 及联合后处理图像可对十二指肠钝性损伤做出较为准确的诊断。MSCT 横断平扫联合后处理图像明显提高对十二指肠钝性损伤的检出率。
目的：探討十二指腸鈍性損傷的 MSCT 診斷。方法：迴顧性分析經手術或臨床證實的36例十二指腸鈍性損傷患者的 MSCT 錶現。所有患者均行 MSCT 橫斷平掃，分彆就平掃、平掃聯閤後處理圖像兩種方法對是否十二指腸鈍性損傷進行雙盲讀片，兩種方法對十二指腸鈍性損傷的檢齣率運用配對四格錶 McNemar 確切概率法χ2檢驗。結果：36例十二指腸鈍性損傷分彆位于十二指腸毬部2例，降部18例，水平部3例，升部3例，降部和水平部交界區10例。十二指腸鈍性損傷的 MSCT 主要錶現為十二指腸腸壁增厚、十二指腸週圍膜脂肪條索影、十二指腸腸壁血腫、腹膜後遊離氣體影、腹膜後積液和腹膜後血腫，其檢齣率分彆為80．6％、91．7％、8．3％、13．8％、30．6％和16．7％。本組綜閤運用 MSCT 徵象對十二指腸鈍性損傷的正確診斷率達88．9％（32／36）。兩種方法對十二指腸鈍性損傷的檢齣率有顯著性差異（P ＝0．031）。結論：十二指腸鈍性損傷的 MSCT 錶現具有一定特點，根據 MSCT 及聯閤後處理圖像可對十二指腸鈍性損傷做齣較為準確的診斷。MSCT 橫斷平掃聯閤後處理圖像明顯提高對十二指腸鈍性損傷的檢齣率。
목적：탐토십이지장둔성손상적 MSCT 진단。방법：회고성분석경수술혹림상증실적36례십이지장둔성손상환자적 MSCT 표현。소유환자균행 MSCT 횡단평소，분별취평소、평소연합후처리도상량충방법대시부십이지장둔성손상진행쌍맹독편，량충방법대십이지장둔성손상적검출솔운용배대사격표 McNemar 학절개솔법χ2검험。결과：36례십이지장둔성손상분별위우십이지장구부2례，강부18례，수평부3례，승부3례，강부화수평부교계구10례。십이지장둔성손상적 MSCT 주요표현위십이지장장벽증후、십이지장주위막지방조색영、십이지장장벽혈종、복막후유리기체영、복막후적액화복막후혈종，기검출솔분별위80．6％、91．7％、8．3％、13．8％、30．6％화16．7％。본조종합운용 MSCT 정상대십이지장둔성손상적정학진단솔체88．9％（32／36）。량충방법대십이지장둔성손상적검출솔유현저성차이（P ＝0．031）。결론：십이지장둔성손상적 MSCT 표현구유일정특점，근거 MSCT 급연합후처리도상가대십이지장둔성손상주출교위준학적진단。MSCT 횡단평소연합후처리도상명현제고대십이지장둔성손상적검출솔。
Objective:To investigate the diagnosis value of MSCT (multi-slice CT)in blunt duodenal injury.Methods:The MSCT appearances of 36 cases with BDIs (blunt duodenal injuries)confirmed by surgery and (or)clinical findings were analyzed retrospectively.All patients underwent MSCT plain scanning of whole abdomen.Two experienced radiologists blinded to the clinical diagnosis,reached a diagnosis from the MSCT findings by two ways of plain scanning and plain scan-ning combined with post-processing MSCT images.The detection rates of BDIs were compared by two-related-samples Mc-Nemar exact probability chi-square test.Results:Thirty-six cases of BDIs were located at the 1st (n=2),2nd (n=18),3rd (n=3)and 4th (n=3)portion of duodenum,respectively,and the other ten cases located at the junction of the 2nd and 3rd portion of duodenum.The MSCT findings of BDIs mainly consisted of duodenal wall thickening,duodenal mesenteric streak-ing,duodenal wall hematoma,free retroperitoneal air,free retroperitoneal fluid and retroperitoneal hematoma.Their detecta-ble rates were 80.6%,91.7%,8.3%,13.8%,30.6% and 16.7% respectively.The accuracy in diagnosis of BDIs with MSCT was 88.9% (32/36)in our study.There was significant statistical difference in detection rate of BDI between plain scanning and plain scanning with postprocessing technique (P =0.031).Conclusion:MSCT manifestations of BDIs have cer-tain characteristics.A more accurate diagnosis of BDIs can be reached using the plain scanning with post-processing MSCT ima-ges.The detection rate of BDIs is increased obviously by the way of plain scanning combined with post-processing MSCT images.
