摘要
目的:回顾性分析经手术证实的下消化道穿孔患者的影像资料,探讨急诊非创伤性下消化道穿孔的影像学诊断方法。方法:收集2005年～2007年我院经手术证实的57位下消化道穿孔患者的影像资料,包括立位腹平片、MSCT平扫或增强扫描及超声成像,所有影像学检查均在手术前24h内完成。以手术及术后病理所见为参考标准,评价立位腹平片、MSCT及超声影像诊断下消化道穿孔的准确性。结果:该组病例中有29例患者在手术前行立位腹平片检查,仅7例(24.1%)出现膈下游离气体。37例患者在手术前腹部超声检查,仅8例(21.6%)发现腹腔内游离气体,这8例患者中有4例(50%)经超声明确诊断了穿孔部位。10例患者在手术前行MSCT腹部平扫或增强扫描,9例患者(90%)的CT影像发现了腹腔内游离气体,其中有8例患者(88.9%)明确了穿孔部位。MSCT平扫或增强扫描发现下消化道穿孔所致腹腔内游离气体准确性明显优于X线立位腹平片(P=0.001)及腹部超声(P<0.001)。MSCT发现下消化道穿孔位置的能力较腹部超声(P=0.08)优越性不明显。结论:急诊腹部MSCT扫描能够准确发现下消化道穿孔所致腹腔内游离气体。
Objective:To discuss emergency diagnostic imaging method in non-traumatic lower gastrointestinal perforation by retrospectively analyzing the imaging of patients with lower gastrointestinal perforation.Methods:The imaging of 57 patients with non-traumatic lower gastrointestinal perforation confirmed by the surgery in our hospital from 2005 to 2007 was retrospectively analyzed,including plain abdominal radiography(PAR),multi-slice spiral CT(MSCT) imaging with/without contrast media,US examination.All imaging study underwent in 24 hours before the surgery.Taken the surgery and pathology reports as the reference standard,the evaluations had been done concerning the precision of PAR,MSCT and US to diagnose lower gastrointestinal perforation.Results:29 patients underwent the PAR before the surgery and only 7 patients(24.1%) were detected the pneumoperitoneum.37 patients underwent the US before the surgery and only 8 patients(21.6%) were detected the pneumoperitoneum,and 4 of the 8 patients(50%) were detected the perforation site.10 patients underwent the MSCT scanning with or without contrast media and 9 patients(90%) were detected the pneumoperitoneum,and 8 of the 9 patients(88.9%) were detected the perforation site.For detecting the pneumoperitoneum secondary to lower gastrointestinal perforation,MSCT scanning was obviously better than PAR(P=0.001) and US(P<0.001).MSCT scanning was not superior to US(P=0.08) for detecting the perforation site.Conclusion:Emergency MSCT abdominal imaging could accurately detect the pneumoperitoneum secondary to lower gastrointestinal perforation.
出处
《医学影像学杂志》
2012年第2期237-240,共4页
Journal of Medical Imaging
关键词
肠穿孔
急诊医学
影像诊断学
Intestinal perforation
Emergency medicine
Diagnostic imaging
