摘要
目的通过分析成人梅克尔憩室(MD)CT表现,探讨多层螺旋CT对MD的诊断价值。方法对34例经手术病理证实为MD患者的CT图像与临床资料进行回顾性分析,包括图像质量评分、MD影像特点及憩室开口位置、长度、最大径、最小径等,并与术中所见进行对比研究评估CT对MD的诊断价值,同时将有、无并发症的复杂型、单纯型憩室进行对比研究,评估CT对MD分型及远期预测的价值。结果34例患者影像质量评分(2.73±0.4)分,其中未行严格肠道准备者评分较低;MD开口于肠系膜对侧肠壁者31例(91.2%),开口于侧壁者3例(8.8%);将CT测量值与手术测量值进行对比研究,发现MD长度、最大径、最小径均高于术中测量值,两种测量方法差异有统计学意义(t=4.830、5.251、3.302,P<0.05)。影像分型为单纯型MD者14例(41.2%),复杂型憩室者20例(58.8%),复杂型憩室均伴发憩室炎;对单纯型与复杂型MD进行对比研究,发现单纯型开口直径、最小直径、开口直径与最小直径之差均高于复杂型,示两种分型差异有统计学意义(t=3.710、3.130、2.455,P<0.05)。结论多层螺旋CT对成人MD诊断、分型、远期预测及手术指导具有重要的临床价值,拟诊MD患者应常规行严格肠道准备及增强扫描。
Objective To evaluate the diagnostic value of multi-slice spiral CT in adult Meckel’s diverticulum(MD)by analyzing the CT findings.Methods CT images and clinical data of 34 patients with MD confirmed by operation were retrospectively analyzed,including image quality score,MD imaging characteristics,diverticulum opening location,length,maximum diameter,minimum diameter,etc.The diagnostic value of CT in MD was evaluated by comparing with the intraoperative findings.Simple diverticulum without complications was compared with complex diverticulum without complications to evaluate the value of CT in MD classification and long-term prediction.Results The image quality score of 34 patients was 2.73±0.4,of which 31(91%)had MD opening in the contralateral mesenteric wall and 3(8.82%)had MD opening in the lateral wall;Comparing the CT measurements with the surgical measurements,it was found that the length,maximum diameter and minimum diameter of MD were higher than the intraoperative measurements,and there was significant difference between the two measurements(t=4.830,5.251,3.302;P<0.05).14 cases(41.18%)had simple MD,20 cases(58.82%)had complex diverticulum,all of which were accompanied by diverticulitis.By comparing simple MD with complex MD,it was found that the difference between simple MD and complex MD was higher than that between simple MD and complex MD(t=3.710,3.130,2.455;P<0.05).Conclusion Multi-slice spiral CT has important clinical value for the diagnosis,classification,long-term prediction and surgical guidance of adult MD.Patients with MD should be routinely performed strict bowel preparation and enhanced scanning.
作者
曾国飞
胡勤勤
杨华
郭大静
ZENG Guofei;HU Qinqin;YANG Hua(Department of Radiology,Chongqi Hospital of Traditional Chinese Medicine,Chongqi 400021,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第7期1356-1361,共6页
Journal of Clinical Radiology
基金
重庆市科研院所绩效激励引导专项项目(编号:cstc2018jxjl130078)
重庆市科卫联合医学科研项目(编号:2019QNXM010)
成都中医药大学医院专项课题(编号:YYZX20180051)
重庆市自然科学基金项目(编号:cstc2020jcyj-msxm X0751)。
