多排螺旋CT多平面重建在腹股沟斜疝、直疝及股疝中的鉴别诊断及临床价值

目的探究多排螺旋CT多平面重建对腹股沟疝的临床鉴别诊断价值。 方法回顾性分析2020年2月至2021年2月内蒙古包钢医院收治的100例同时行多排螺旋CT多平面重建扫描及疝修补术的病例，观察疝的影像学征象，类型及发生侧，以手术结果为金标准，分析比较多排螺旋CT多平面重建诊断腹股沟疝的准确率、灵敏与特异度以及阴阳性预测值。 结果100例患者共有116个疝囊，多排螺旋CT多平面重建扫描诊断腹股沟斜疝的灵敏及特异度分别为93.33%、94.44%，阴阳性预测值分别为92.73%和94.91%；腹股沟直疝的上述指标分别为91.67%、95.65%、96.70%、89.19%；股疝上述指标均为100%。多排螺旋CT检查示股疝疝囊则位于腹股沟韧带后下方，存在股三角填塞，腹股沟斜疝和直疝疝囊均位于腹股沟韧带前上方，且不存在股三角填塞，但腹股沟斜疝疝囊位于腹壁下动脉外侧，直疝疝囊位于腹壁下动脉内侧，伴侧新月征。 结论斜疝、直疝和股疝具有特征性影像学征像，多排螺旋CT多平面重建可以显示腹股沟区解剖细节，对斜疝、直疝和股疝的诊断与鉴别诊断有重要价值。

Clinical value of multi-slice spiral CT multi-plane reconstruction in the differential diagnosis of indirect inguinal hernia,direct inguinal hernia and femoral hernia

ObjectiveTo explore the clinical value of multi-slice spiral CT multi-plane reconstruction in the differential diagnosis of inguinal hernia. MethodsA retrospective analysis was performed on 100 patients who received simultaneous multi-slice spiral CT multi-plane reconstruction and hernia repair in Inner Mongolia Baotou Iron and steel hospital from February 2020 to February 2021. The imaging signs, types and occurrence sides of hernia were observed, and the surgical results were considered as the gold standard. To analyze and compare the accuracy, sensitivity, specificity, negative and positive predictive value of multi-slice spiral CT multi-plane reconstruction in the diagnosis of inguinal hernia. ResultsThere were 116 hernia sacs in 100 patients. The sensitivity and specificity of multi-slice spiral CT multi-plane reconstruction in the diagnosis of indirect inguinal hernia was 93.33% and 94.44%, and the negative and positive predictive values were 92.73% and 94.91%, respectively. The above indexes of direct inguinal hernia were 91.67%, 95.65%, 96.70% and 89.19%, respectively. The above indexes of femoral hernia were all 100%. Multi-slice spiral CT examination showed that femoral hernia sac was located below after the inguinal ligament, with triangle tamponade. The indirect inguinal hernia and direct hernia sac were located above before the inguinal ligament, without triangle tamponade, but the indirect inguinal hernia sac was located lateral to the inferior epigastric artery, direct hernia sac was located medial to the inferior epigastric artery, with lateral crescent. ConclusionIndirect inguinal hernia, direct inguinal hernia and femoral hernia have characteristic imaging features. Multi-slice spiral CT multi-plane reconstruction can reveal the anatomical details of the inguinal region, which is of great value in the diagnosis and differential diagnosis of indirect, direct inguinal hernia and femoral hernia.