螺旋CT评价急性胃肠道穿孔部位的价值
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- 英文论文题名：The Value and Significance of CT in the Diagnosis of Acute Gastrointestinal Tract Perforation
- 论文作者：魏娟 ; 张延伟 ; 李忠民 ; 莫卓均
- 英文论文作者：Wei Juan ; Zhang Yanwei ; Li Zhongmin ; Guangzhou University of TCM ; Department of medical imaging ; The 3rd Affiliated Hospital of Guangzhou University of TCM ; Department of interventional ; Shouguang city TCM Hospital
- 年：2017
- 作者机构：广州中医药大学;广州中医药大学第三附属医院;山东省潍坊市寿光市中医医院介入导管室;
- 论文关键词：胃肠道穿孔 ; x线 ; 体层摄影术
- 英文论文关键词：Gastrointestinal tract perforation ; Free air ; Signs ; CT
- 会议召开时间：2017-05-26
- 会议录名称：2017年《中国组织化学与细胞化学杂志》临床研讨会论文集
- 语种：中文
- 分类号：R656;R816.5
- 学会代码：ZHXB
- 会议名称：2017年《中国组织化学与细胞化学杂志》临床研讨会
- 会议地点：中国湖北武汉
- 主办单位：《中国组织化学与细胞化学杂志》社有限公司
- 学会名称：《中国组织化学与细胞化学杂志》社有限公司
- 页数：2
- 文件大小：516k
- 原文格式：O
- 会议级别：全国
摘要
目的:初步探讨螺旋CT对急性胃肠道穿孔的部位判定的价值。方法:回顾性分析71例急性胃肠道穿孔患者的CT图像,评价游离气体的位置、腹水、周围脂肪间隙模糊征及局部胃肠壁增厚在急性胃肠道穿孔中的分布位置及或出现的百分比。结果:门静脉周围游离气体征在上消化道穿孔出现的概率(31/57,54.39%)高于下消化道穿孔(4/16,25%,P=0.038);镰状韧带征及圆韧带征在上下消化道穿孔出现的概率差异不具有统计学意义。小肠结肠周围积气下消化道穿孔出现的概率(11/16,68.75%)高于上消化道穿孔(1/57,1.75%,P=0.038),差异具有统计学意义。腹水、周围脂肪间隙模糊征及肠壁不连续在急性上下消化道穿孔中所占比值为67.12%、41.09%、17.81%。结论:CT显示游离气体的位置对鉴别急性胃肠道穿孔位置有重要价值,门静脉周围游离气体征提示上消化道穿孔,而小肠结肠周围积气提示急性下消化道穿孔,局部脂肪间隙模糊征及胃肠壁增厚可进一步缩小穿孔部位。
Objective:To assess the value and significance of computer tomography(CT) in the diagnosis of acute gastrointestinal(GI) tract perforation.Methods:Abdominal CT images of 71 patients with surgically proven GI tract perforation were analyzed retrospectively.The distribution of free air,segmental bowel wall thickenings perivisceral fat stranding and localised fluid collection were evaluated and compared between upper and lower acute GI tract perforation.Results:The incidence rates of the PPFA sign in acute upper GI tract perforation(54.39%) was higher than that in acute lower GI tract perforation(25%).The incidence rates of the flaciform ligament sign and the ligamentum teres sign were not significantly different between the acute upper and lower GI tract perforation group.The incidence rates of free air around small intestine and colon in lower GI tract(68.75%) was higher than that in acute lower GI tract perforation(1.75%).The incidence rates of segmental bowel wall thickening、perivisceral fat stranding and localised fluid collection was 17.81%、41.09%and67.12%.Conclusion:The distribution of free air on CT is useful in the differential diagnosis of acute GI tract perforation,periportal free air(PPFA) sign is suggestive of upper GI tract perforation while free air around small intestine and colon is suggestive of lower GI tract perforation.The egmental bowel wall thickening、perivisceral fat stranding and localised fluid collection are very important signs in diagnosis of acute gastrointestinal(GI) tract perforation.
Objective:To assess the value and significance of computer tomography(CT) in the diagnosis of acute gastrointestinal(GI) tract perforation.Methods:Abdominal CT images of 71 patients with surgically proven GI tract perforation were analyzed retrospectively.The distribution of free air,segmental bowel wall thickenings perivisceral fat stranding and localised fluid collection were evaluated and compared between upper and lower acute GI tract perforation.Results:The incidence rates of the PPFA sign in acute upper GI tract perforation(54.39%) was higher than that in acute lower GI tract perforation(25%).The incidence rates of the flaciform ligament sign and the ligamentum teres sign were not significantly different between the acute upper and lower GI tract perforation group.The incidence rates of free air around small intestine and colon in lower GI tract(68.75%) was higher than that in acute lower GI tract perforation(1.75%).The incidence rates of segmental bowel wall thickening、perivisceral fat stranding and localised fluid collection was 17.81%、41.09%and67.12%.Conclusion:The distribution of free air on CT is useful in the differential diagnosis of acute GI tract perforation,periportal free air(PPFA) sign is suggestive of upper GI tract perforation while free air around small intestine and colon is suggestive of lower GI tract perforation.The egmental bowel wall thickening、perivisceral fat stranding and localised fluid collection are very important signs in diagnosis of acute gastrointestinal(GI) tract perforation.
引文
[1]Samuel Borofsky,Myles Taffel,et al.The emergency room diagnosis of gastrointestinal tract perforation:the role of CT[J].Emerg Radiol(2015)22:315-327.
[2]Sola Oguro.Tomohiro Funahiki,et al.64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site:detectability of direct findings in upper and lower GI tract[J].Eur Radiol.2010,20:1396-1403
[3]Hyun Cheol Kim.Dal Mo Yang,et al.Gastrointestinal tract perforation:evaluation of MDCT according to perforation site and elapsed time[J].Eur Radiol(2014)24:1386-1393.
[4]Hainaux B,Agneessens E,Bertinotti R,et al.Accuracy of MDCT in predicting site of gastrointestinal tract perforation[J].Am J Roentgenol2006,187:1179-1183
[5]Cho H.S.,Yoon S.E.,Park S.H.,Park H.,Lee Y.H.,and Yoon K.H.:Distinction between upper and lower gastrointestinal perforation:usefulness of the periportal free air sign on computed tomography[J].Eur J Radiol.2009,69:108-113
[6]谭源满,曾旭文等.CT游离气体分布对鉴别上/下消化道穿孔的价值[J].放射学实践.2014,29(11):1297-1299.
[7]Choi AL,Jang KM,Kim MJ et al.What determines the periportal free air,and ligamentum teres and falciform ligament signson CT:can these specific air distributions be valuable predictors of gastroduodenal perforation?[J].Eur J Radiol.2011,77:319-324.
[2]Sola Oguro.Tomohiro Funahiki,et al.64-slice multidetector computed tomography evaluation of gastrointestinal tract perforation site:detectability of direct findings in upper and lower GI tract[J].Eur Radiol.2010,20:1396-1403
[3]Hyun Cheol Kim.Dal Mo Yang,et al.Gastrointestinal tract perforation:evaluation of MDCT according to perforation site and elapsed time[J].Eur Radiol(2014)24:1386-1393.
[4]Hainaux B,Agneessens E,Bertinotti R,et al.Accuracy of MDCT in predicting site of gastrointestinal tract perforation[J].Am J Roentgenol2006,187:1179-1183
[5]Cho H.S.,Yoon S.E.,Park S.H.,Park H.,Lee Y.H.,and Yoon K.H.:Distinction between upper and lower gastrointestinal perforation:usefulness of the periportal free air sign on computed tomography[J].Eur J Radiol.2009,69:108-113
[6]谭源满,曾旭文等.CT游离气体分布对鉴别上/下消化道穿孔的价值[J].放射学实践.2014,29(11):1297-1299.
[7]Choi AL,Jang KM,Kim MJ et al.What determines the periportal free air,and ligamentum teres and falciform ligament signson CT:can these specific air distributions be valuable predictors of gastroduodenal perforation?[J].Eur J Radiol.2011,77:319-324.