中国CT和MRI杂志
中國CT和MRI雜誌
중국CT화MRI잡지
Chinese Journal of CT and MRI
2015年
11期
98-100,107
,共4页
胃肠道穿孔%腹膜病变%X线%计算机
胃腸道穿孔%腹膜病變%X線%計算機
위장도천공%복막병변%X선%계산궤
Gastrointestinal Perforation%Peritoneum Lesion%X-ray Computed
目的：探讨急性胃肠道穿孔继发腹膜病变的CT表现，提高对穿孔性腹膜炎的影像学诊断与鉴别能力。方法对36例拟诊穿孔性腹膜炎患者行CT扫描，着重观察与腹膜炎相关的6种CT征象并作出术前诊断，其中28例在CT扫描后24小时内手术，并经手术和病理证实穿孔性腹膜炎的部位及程度，8例经临床综合指标明确诊断；分别计算与穿孔性腹膜炎相关的6种CT征象诊断的敏感度，特异度及正确率，术前CT诊断与临床手术病理对照采用相关系数法检验。结果术前综合运用主要CT征象对穿孔性腹膜炎的正确诊断率为86.1%(31/36）,穿孔性腹膜炎的主要CT表现为腹腔游离气体影、腹腔积液、胃肠道壁增厚、壁腹膜增厚、肠系膜条纹征、肠郁张，其敏感度分别为82.1%、92.8%、67.8%、75%、89%、53.6%，特异度为25%、37.5%、62.5%、100%、89.3%、75%，腹腔积液、壁腹膜增厚、肠系膜条纹征与腹膜炎诊断有显著相关性(P<0.05)。结论根据CT征象可在术前对穿孔性腹膜炎做出较为准确的诊断。
目的：探討急性胃腸道穿孔繼髮腹膜病變的CT錶現，提高對穿孔性腹膜炎的影像學診斷與鑒彆能力。方法對36例擬診穿孔性腹膜炎患者行CT掃描，著重觀察與腹膜炎相關的6種CT徵象併作齣術前診斷，其中28例在CT掃描後24小時內手術，併經手術和病理證實穿孔性腹膜炎的部位及程度，8例經臨床綜閤指標明確診斷；分彆計算與穿孔性腹膜炎相關的6種CT徵象診斷的敏感度，特異度及正確率，術前CT診斷與臨床手術病理對照採用相關繫數法檢驗。結果術前綜閤運用主要CT徵象對穿孔性腹膜炎的正確診斷率為86.1%(31/36）,穿孔性腹膜炎的主要CT錶現為腹腔遊離氣體影、腹腔積液、胃腸道壁增厚、壁腹膜增厚、腸繫膜條紋徵、腸鬱張，其敏感度分彆為82.1%、92.8%、67.8%、75%、89%、53.6%，特異度為25%、37.5%、62.5%、100%、89.3%、75%，腹腔積液、壁腹膜增厚、腸繫膜條紋徵與腹膜炎診斷有顯著相關性(P<0.05)。結論根據CT徵象可在術前對穿孔性腹膜炎做齣較為準確的診斷。
목적：탐토급성위장도천공계발복막병변적CT표현，제고대천공성복막염적영상학진단여감별능력。방법대36례의진천공성복막염환자행CT소묘，착중관찰여복막염상관적6충CT정상병작출술전진단，기중28례재CT소묘후24소시내수술，병경수술화병리증실천공성복막염적부위급정도，8례경림상종합지표명학진단；분별계산여천공성복막염상관적6충CT정상진단적민감도，특이도급정학솔，술전CT진단여림상수술병리대조채용상관계수법검험。결과술전종합운용주요CT정상대천공성복막염적정학진단솔위86.1%(31/36）,천공성복막염적주요CT표현위복강유리기체영、복강적액、위장도벽증후、벽복막증후、장계막조문정、장욱장，기민감도분별위82.1%、92.8%、67.8%、75%、89%、53.6%，특이도위25%、37.5%、62.5%、100%、89.3%、75%，복강적액、벽복막증후、장계막조문정여복막염진단유현저상관성(P<0.05)。결론근거CT정상가재술전대천공성복막염주출교위준학적진단。
Objective To discuss CT manifestations of peritoneum lesion due to gastrointestinal perforation, and develop the imaging diagnosis and differential diagnosis of perforation peritonitis.Methods 36 cases of suspected perforation peritonitis were examined by CT scanning, among which 28 cases underwent surgery within 24 hours of CT scanning, and the region and the degree of peritonitis were confirmed by surgery and pathology. The other 8 cases were definitive diagnosed by clinical comprehensive indicators. The sensitivity, specificity and overall accuracy of diagnosis of 6 kinds of CT signs associated perforated peritonitis were calculated separately. Correlation coefficient method was used to test the preoperative CT diagnosis and pathologic.Results Correct diagnostic rate of using the main CT signs of perforation peritonitis before operation was 86.1% (31/36). The main CT manifestations of Perforation peritonitis were celiac free gases, peritoneal effusion, thickening of the gastrointestinal tract wall, wall peritoneal thickening, mesenteric adipose stripe and intestinal stasis dilatation. The sensitivity separately were 82.1%, 92.8%, 67.8%, 75%, 89%, 53.6%, and the specificity separately were 25%, 37.5%, 62.5%, 100%, 89.3%, 75%. Peritoneal effusion, wall peritoneal thickening and mesenteric adipose stripe have significant correlation with peritonitis diagnosis (P<0.05).Conclusion CT signs can make more accurate diagnosis to perforation peritonitis prior to surgery.
