外伤性胃肠道破裂穿孔的MSCT诊断

目的评价MSCT在外伤性胃肠道破裂穿孔诊断中的价值。方法回顾性分析16例经手术证实的外伤性胃肠道穿孔患者的影像资料，并进行统计学分析。所有x线平片与MSCT图像均由两名高年资放射科医师共同阅片，分析总结有价值MSCT征象。结果MSCT栓出隔下游离气体征（n=12）；腹脏内游离积液征（n=14）；肠壁区域性水肿增厚模糊（n=10）；肠壁外或肠壁间积气征（n=11）；胃肠壁周围肠系膜密度增高模糊，呈液性渗透征（n=6）。x线平片和MSCT对膈下游离气体检出率分别31．3％和75％，两种检查方法检出率比较差异有统计学意义（P〈0．05）。超声检查和MSCT对腹腔少量积液的检出分别为75％和87．5％，两种检查方法检出率比较差异无统计学意义（P〉0．05）。结论细致分析MSCT薄层重建、多平面重建图像能发现一些重要依据，MSCT对外伤性胃肠道穿孔的诊断具有较高价值。

MSCT diagnosis of traumatic gastrointestinal tract perforation

Objective To evaluate the significance of MSCT diagnosis on gastrointestinal（GI） perforation. Methods The images of 16 eases with confirmed by operation were reviewed and statistically analyzed. All X-ray pictures and MSCT images were analyzed by two senior radiologists together and summarized the significant MSCT manilfestations. Results MSCT detected sub-diaphragm sign of free gas （ n = 12 ）. intra-abdominal free effusion （ n = 14 ） , ambiguity of local intestinal edemacn （ n = 10 ）. ex- tra-intestinal pneumatosis（ n = 11 ）. fluid infiltration of peri-gastrointestinal mesentery （n = 6）. The detection rates of X-ray and MSCT on sub-diaphragm free gas were 31.3% and 75% respectively. There was significant difference between these two methods （P〈0. 05）. The detection rates of ultrasonic examination and MSCT on intra-abdominal free effusion were 75% and 87.5% re- spectively, without significant difference （ P〉0.05 ）. Conclusion Carefully analysis of lamellar reconstrution and poly-plane re- construction images helps to detect some important sings. MSCT is significant in diagnosise of gasintestinat.