腹腔手术后肠粘连的MRI及CT诊断

目的：探讨腹腔及盆腔手术后短期及慢性肠粘连的MRI、CT征象及诊断。方法：选择74例腹盆腔手术后因怀疑肠粘连而留院患者,在二次手术前行MRI和CT扫描并与手术对照。结果：MRI、CT诊断肠粘连并术中证实粘连者62例（83.8%）;其中伴粘连性梗阻32例,肠袢粘连区结构紊乱固定14例。胆道术后粘连28例,恶性肿瘤术后复发恶性粘连19例。假阳性8例（10.8%）,假阴性4例（5.4%）。结论：MRI及CT能比较敏感地发现并评价肠粘连。假阳性主要是由于肠道准备不足、扫描时间不足够长所致;假阴性主要由于粘连带过小。

MRI and CT Diagnosis on Postoperative Intestinal Adhesion

Objective To explore the MRI and CT signs and diagnosis on postoperative short-term and chronic intestinal adhesion.Methods 74 patients suspected suffered with intestinal adhesion after abdominal or pelvic surgery were selected.Pre-operative MRI and CT scan were performed before a second operation.Compared the MRI and CT findings with that during the second operation.Results 62 cases（83.8%） that were diagnosed intestinal adhesion by MRI and CT were proved during operation：32 patients were of adhesive insfestinal obstruction and 14 bowl disorganization resulted from adhesion.Biliang tract operation was 28 cases;malignant adhesion due to tumor recurrence were 19 cases.False positive were 8 caces（10.8%）,and false negative were 4 cases（5.4%）.Conclusion MRI and CT can sensitively demonstrated intestinal adhesion that can be further evaluated objectively.False positive were mostly due to insufficient bowel preparation before scan and insufficient delay time during scan.False negative were due to that the adhesion was too small to properly display.