多层螺旋CT后处理技术在小肠梗阻中的价值

目的评价多层螺旋CT后处理技术对小肠梗阻性疾病的临床应用价值。方法回顾性分析45例经临床手术病理证实的A、B、C三组小肠梗阻CT影像,A组为单纯性的螺旋CT横断面图像,B组为单纯性MPR后处理图像,C组为螺旋CT横断面图像并辅以MPR(multiple planiar rendering,MPR)后处理图像。结果45例中,包括粘连13例,肿瘤11例,肠扭转7例,肠套叠5例,腹外疝4例,胆石3例,内疝2例。A、B、C三组均能确定肠梗阻的存在,A组能确定26例(57.8%)梗阻部位及28例(62.2%)梗阻原因,B组能确定29例(64.4%)梗阻部位及31例(68.9%)梗阻原因,C组能确定43例(95.6%)梗阻部位及44例(97.8%)梗阻原因,A、B两组对梗阻部位和原因的诊断无明显差异(p>0.05),但C组诊断不论在梗阻部位或梗阻原因方面优于A或/和B组(p<0.05)。结论多层螺旋CT横断面图像结合MPR后处理,能大大提高小肠梗阻诊断的准确性。

Clinical Evaluation of Post-processing Technique on Multi-slice Spiral CT in Small Bowel Obstruction Examination

Objective To evaluate the clinical value of post-processing technique on multi-slice spiral CT in diagnosis of small bowel obstruction. Methods CT images of 45 cases with small obstruction confirmed by operation and pathology were classified into Group A, Group B and Group C, and analyzed retrospectively. Group A was the simple axial spiral CT images, Group B the simple MPR post- processing images, Group C the axial spiral CT images supplemented with MPR post-processing images. Results Among the 45 cases, there were 13 cases with adhesion, 11 with tumor, 7 with volvulus, 5 with intussusception, 4 with abdominal external hernia, 3 with gallstone and 2 with internal hernia. The existence of ileus could be determined in all the three groups. The bowel obstruction sites of 26 cases （57.8%） in Group A, 29 cases （64.4%） in Group B and 43 cases （95.6%） in Group C could be determined respectively; the bowel obstruction etiology of 28 cases （62.2%） in Group A, 31 cases （68.9%） in Group B and 44 cases （97.8%） in Group C could be determined respectively. No significant differences in the diagnosis of bowel obstruction site and etiology were found between Group A and Group B （p 〉 0.05）. but in terms of the two diagnoses, Group C was significantly better than Group A or/and Group B （p 〈 0.05）. Conclusuion The axial muhi-slice spiral CT image supplemented with MPR post-processing image can significantly increase the accuracy of diagnosis of small bowel obstruction.