摘要
目的探讨多排螺旋CT(multi-detector row spiral CT,MDCT)及三维重建技术对成人肠套叠的应用价值。方法纳入经手术和临床随访证实的21例肠套叠患者,其中平扫3例,增强扫描18例。将原始图像采用多平面重组(multi-planar reconstruction,MPR)技术进行三维重建,并将患者的图像分为原始图像组和原始图像加MPR图像组。由2位从事腹部放射诊断的医师回顾性分析患者的影像资料,记录2组图像对肠套叠诊断的准确率和医生的信心指数,包括诊断、定位、发现原因、是否有血运障碍及肠梗阻,2组之间进行比较。结果原始图像组和原始图像加MPR图像组图像对肠套叠的诊断、定位、发现原因、是否有血运障碍及肠梗阻指标的准确率分别为90.5%(19/21)比100%(21/21)、81.0%(17/21)比95.2%(20/21)、85.7%(18/21)比90.5%(19/21)、90.9%(10/11)比90.9%(10/11)和100%(11/11)比100%(11/11),2组之间各指标的准确率差异均无统计学意义(P>0.05)。对肠套叠的诊断、定位和发现原因方面,原始图像加MPR图像组医生信心指数大于原始图像组(5.00比4.24、4.76比4.29和4.29比3.71),差异均有统计学意义(P<0.05)。结论MDCT对肠套叠的诊断、定位、寻找引起肠套叠原因、评价套叠肠管的血运状态等方面有重要价值;与单纯轴位图像相比,轴位图像结合三维重建图像能提高医生的诊断信心。
Objective To investigate the value of the multi-detector row spiral CT（MDCT） and 3-dimensional reconstruction technique for adult intussusception.Methods Twenty-one patients with surgically and clinical following-up confirmed intussusception were retrospectively included into this study.Three patients had plain MDCT scan,18 received contrast enhanced MDCT scan.The original images were reconstructed with multi-planar reconstruction（MPR） technique and all the images of 21 patients were divided into original image group and original image add MPR image group.Two abdominal radiologists analyzed the MDCT imaging and recorded respectively the accuracy rate and the confidence index of the doctor about following indexes： whether or not having intussusception,the location of intussusception,finding reason caused intussusception,whether or not having bowel wall ischemia and whether or not having bowel obstruction.The accuracy rate and the confidence index of the doctor were compared using a SPSS statistics software.Results The accuracy rates about above indexes between original image group and original image add MPR image group were 90.5%（19/21） vs.100%（21/21）,81.0%（17/21） vs.95.2%（20/21）,85.7%（18/21） vs.90.5%（19/21）,90.9%（10/11） vs.90.9%（10/11） and 100%（11/11） vs.100%（11/11） respectively,and there was no significant difference between original image group and original image add MPR image group（P0.05）.For following indexes： whether or not having intussusception,the location of intussusception,finding reason caused intussusception,the confidence index of the doctor between original image add MPR image group and original image group had significant difference（5.00 vs.4.24,4.76 vs.4.29,4.29 vs.3.71）,and the confidence index of the doctor of original image add MPR image group exceeded that of original image group（P0.05）.Conclusions MDCT plays a valuable role in diagnosis and location of intussusception,finding the reason caused intussusception and evaluation the hemodynamic impairment of being involved in bowel wall.Compared to simple axial image,axial image combine 3-dimensional reconstructed image can increase the diagnostic confidence of the doctor.
出处
《中国普外基础与临床杂志》
CAS
2009年第10期856-860,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
肠套叠
断层摄影术/X线计算机
重建
信心指数
Intussusception
Tomography/X-ray computed
Reconstruction
Confidence index
