多排螺旋CT多平面重建技术对肠梗阻诊断价值

目的通过回顾性分析肠梗阻病例的CT资料,探讨多平面重建(MPR)技术对肠梗阻的诊断价值。方法对2008年1月至2011年6月上海市奉贤区中心医院收治的71例肠梗阻患者的CT横轴位图像和在横轴位基础上对兴趣区MPR技术处理后的图像进行分析,评估MPR对肠梗阻诊断的准确性。结果 16排螺旋CT对梗阻部位诊断准确率单纯横轴位为81.7%(58/71),结合MPR为91.5%(65/71)(P>0.05),但是MPR后使不同阅片者双盲法诊断的一致性得到提高,k值分别为0.556,0.577(均P=0.001),结合MPR前诊断信心平均值为(2.94±0.69)分,结合MPR后诊断信心平均值为(3.05±0.71)分,结合MPR使阅片者的信心有所提高(P<0.01)。对病因诊断准确率MPR前为71.8%(51/71),MPR后为90.1%(64/71)(P<0.05)。结论多排螺旋CT MPR处理后可提高肠梗阻病因诊断率,使不同阅片者对部位诊断的一致性得到提高,并提高阅片者的信心。多层螺旋CT扫描结合MPR技术可考虑作为肠梗阻的首选影像学检查方法。

Comparison of Diagnosis of Intestinal Obstructions before and after Multi-planner Reconstruction Technique of MSCT

Objective To evaluate the role of multi-planar reconstruction（MPR.） technique in diagnosis of intestinal obstructions. Methods A total of 71 cases of intestinal obstruction patients admitted by Fengxian District Central Hospitalduring Jan. 2008 and Jun. 2006 were included, CT axial images and images of MPR disposed position were analyzed, and the accuracy of MPR in the diagnosis of intestinal obstruction was assessed. Results Through 16 slice spiral CT scan,the diagnostic accuracy in simple axial group to display location of obstruction was 81.7% （58/71） ;and was 91.5% （65/71） combined with MPR technique（ P 〉 0.05 ）, combined with MPR, consistency of diagnosis of different observers was improved, the k value were respectively 0. 556,0. 577 （both of the P value were 0. 001 ）, the confidence average value before combina- tion with MPR was（2.94 ±0. 69） ,after combination with the MPR was （3.05 ±0.71 ） ,which indicated that combination with MPR the confidence of readers was enhanced （ P 〈 0.01 ） ; the accuracy to diagnose the cause of obstruction in simple axial group was 71.8% （51/71） ,and 90.1% （64/71）with combination with MPR（P 〈 0.05 ） respectively. Conclusion MPR disposal of MSCT can improve the accuracy for diagnosis of cause of intestinal obstruction significantly, after MPR, consistency of diagnosis of different observers is improved, and the readers＇ confidence can be enhanced. MSCT combined with MPR technique can be consid- ered as the first choice of imaging examination for intestinal obstruction.