中空脏器穿孔的CT诊断

目的:评价CT对中空脏器穿孔的诊断价值。方法:经手术和/或临床随访证实的中空脏器穿孔61例,于发病后1h~7d内行CT扫描。常规采用腹窗(窗宽300HU,窗位20HU)及纵隔窗(窗宽600HU,窗位-30HU)观察腹腔内游离气体及相关病变。结果:CT检查可确认腹腔内游离气体的存在(100%)及分布,可清晰显示腹腔渗液、穿孔部位周围炎性改变、反射性肠郁张、脓肿、胸水等间接征象。CT对穿孔部位的诊断符合率为62.3%,对穿孔原因的诊断符合率为52.5%。结论:CT检查是中空脏器穿孔的有效诊断手段,对穿孔的确认、穿孔部位和病因的判断有价值。

CT Diagnosis of Perforation of Hollow Viscera

Objective:To evaluate the diagnostic value of CT in perforation of the hollow viscera.Methods:Sixty-one patients with suspected perforation accepted CT scan 1 hour to 7 days after clinical onset.CT imaging were analyzed in both abdominal setting (300HU/20HU) and mediastinal setting (600HU/-30HU).Based on the CT findings,the perforated visceras and the etiology were evaluated.Results:CT can clearly show the existence and distribution of extraluminal air escaped from perforated hollow viscera (100%),and display the indirect findings such as abdominal fluid accumulation,inflammatory reaction,abscess formation,adynamic ileus and pleurisy,et al.Of the 61 patients,the sensitivity of CT in diagnosis the site of perforated viscera was 62.3%.and the accuracy of etiology ascertained by CT was 52.5%.Conclusion:CT is a valuable method in the diagnosis of the hollow viscera perforation.It is helpful in the diagnosis of the site and cause of the perforation.