【摘要】 目的 探讨多层螺旋CT(MSCT)对腹壁切口疝术前诊断价值。方法 收集本院经手术病理证实的腹壁切口疝患者30例。所有患者均行MSCT检查,并行多平面重建(MPR),21例行超声(US)检查;观察切口疝数目、部位、内容物、有无肠梗阻等并发症,比较MSCT横断位与MPR及MSCT与US在观察上述方面的差别。结果 30例中,共有切口疝40处,MSCT和US检出率分别为97.5%、56.0%,MSCT较US检出更有优势(P=0.000)。MSCT横断位与MPR检出孤立性切口疝无明显差异(P=1.000),MPR检出2处或多处切口疝较横断面好(P=0.006),且矢状位较冠状位更有优势(P=0.019)。此外,MSCT准确显示切口疝并发症,包括肠梗阻7例,肠壁水肿缺血5例及疝口处转移灶1例,US均未提示。结论 MSCT对腹壁切口疝术前诊断及并发症显示具有重要价值,可为临床治疗提供参考。更多还原

【Abstract】 Objective To evaluate the diagnostic value of multi-slice computed tomography(MSCT) for incisional hernia of abdominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultrasound(US) examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,contents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and compaired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5 % and 56.0%,respectively.MSCT performed better than US on demonstrating the incisional hernias(P=0.000).On MSCT,there was no significant difference in the detection for isolated incisional hernia between the MPRs and axial scans(P=1.000).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis(P=0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias(P=0.019).Furthermore,MSCT can exactly reveal the complications of incisional hernias(7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of metastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.更多还原