64层螺旋CT对急性小肠梗阻病因的诊断价值(1)
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【中图分类号】R574.5【文献标识码】A【文章编号】1005-2720(2009)04-0137-04
【摘要】目的：分析不同原因所致急性小肠梗阻的多层螺旋CT(multi-spiral computed tomography，MSCT)表现特征，探讨MSCT在诊断急性小肠梗阻病因的诊断价值。方法：对142例经64层SCT检查诊断为肠梗阻的病例进行回顾性分析。分析其MSCT表现、诊断结果，并与术后病理结果或临床随访结果对照。结果：142例患者MSCT诊断结果均与术后病理结果或临床随访结果相符合，而腹部平片仅为49.17%(59/120)。对142例肠梗阻病因诊断结果中，CT诊断符合率分别为肠粘连76.60%(36/47)，肿瘤性梗阻90.70%(39/43)，腹内、外疝92.86%(13/14)，炎症性疾病70.00%(7/10)，粪石100.00%(10/10)，肠套叠100.00%(11/11)，血运性肠梗阻100.00%(5/5)，肠扭转100.00%(2/2)。CT对病因诊断总体敏感性86.62%(123/142)，特异性为86.62%(123/142)，假阳性为7.04%(10/142)，假阴性为13.38%(19/142)；而CT检查前病因诊断正确率21.13%(30/142)。结论：MSCT检查能明显提高急性小肠梗阻病因的诊断率，是肠梗阻有效、简便、安全的检查方法之一。
【关键词】小肠梗阻；多层螺旋CT；病因；诊断
The value of 64-slice spiral CT in the etiological diagnosis of acute small-bowel obstruction.Zhao Xingsheng，Li Kuiguang，Zhou Maoyi，et al.(1Affiliated hospital of Weifang medical college，Shandong 261031，China；2Tianliu hospital of Shouguang city)
【Abstract】Objective：To analysis the 64-slice spiral CT manifestations and to access the CT values in etiology diagonosis of acute small-bowl obstruction.Methods：MSCT findings，including manifestations and diagonosises，in 142 cases with acute small-bowel obstruction，proved by surgery or clinical follow-up were retrospectively analyzed.Results：CT findings in the 142 cases were all consistent with the final diagonisis，while the accuracy in diagonosis of x-ray plain flim was only 49.17%(59/120).The causes of small-bowel obstruction included adhesion(76.60%，36/47)，neoplasm(90.70%，39/43)，hernia(92.90%，13/14)，inflammatory disease(70.00%，7/10)，enterolith(100%，14/14)，intussusception(100%，5/5)，ischemia(100%，5/5).The total sensitivity of etiology diagnosis by CT was 86.62%(123/142)，specificity was 86.62%(123/142)，false positive was 7.04%(10/142)and false negative was 13.38%(19/142).The accuracy of the causes of obstruction before CT scan was only 21.13%(30/142).Conclusion：MSCT is useful in establishing the cause diagonosis of acute small-bowl obstruction，and it is an effective，convenient and safe check method.
【Key Words】Small-bowel obstruction；64-slice CT；Pathogeny；Diagnosis ......
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