多层螺旋CT与磁共振SSFSE序列在肠梗阻诊断价值中的对比研究

目的：探讨和比较增强多层螺旋CT和磁共振SSFSE序列在肠梗阻诊断中的价值，探寻对肠梗阻诊断更加有效的影像学手段。方法：回顾68例有肠梗阻症状的患者的增强CT扫描与MRI的SSFSE序列图像，评价两种影像学检查方法对肠梗阻诊断的敏感性、特异性和准确性。结果：68例患者中有56例最终临床诊断为肠梗阻，其中小肠梗阻为35例，结肠梗阻为21例。导致梗阻的原因中，纤维粘连占25例，原发或转移肿瘤占26例，炎性肠病占5例。多层螺旋CT对肠梗阻的诊断灵敏度为89．3％，特异度为83．3％；采用SSFSE序列的MRI诊断，其灵敏度为94．6％，特异度为100％；两种技术对肠梗阻诊断的准确性差异无统计学意义（z。=42．637，P=1．000）。结论：多层螺旋CT和MRI的SSFSE序列对肠梗阻诊断均具有很高的准确性，但MRI相对于CT而言具有无辐射、无需造影剂等优点。

Comparison between multi-slice helical CT and MR SSFSE sequence in imaging diagnosis ofintestinal obstruction]

Objective： To compare the diagnostic values of multislice helical CT and MR SSFSE sequence in imaging diagnosis of intestinal obstruction. Subjects and Methods： The enhanced CT and MR singleshot fast spin echo （SSFSE） images of 68 patients suffered from symptoms of intestinal obstruction were reviewed retrospectively. The sensitivity, specificitvand accuracy of each modality were evaluated. Results： Fifty-six among the 68 patients were clinically diagnosed as intestinal obstruction. Among the 56 cases, 55 were obstructed at small intestine and 21 at colon. The causes of obstruction included fibrotic adhesion （25 cases）, primary or metastatic tumors （26 cases） and inflammatory bowel diseases （5cases）. The sensitivity of multi-slice helical CT in diagnosing intestinal obstruction is 89.3% and specificity is 83.3%. The sensitivity of SSFSE sequence is 94.6% and specificity is 100%. There is no significant difference in diagnostic accuracy of multislice CT and MR SSFSE sequence in diagnosing intestinal obstruction （P= 1.000）. Conclusion Multislice CT and MR SSFSE sequence are both very accurate in diagnosing intestinal obstruction. Compared with CT, MR has some advantages, such as no ionizing radiation, no need of contrast medium and so on.