摘要
目的探讨多排螺旋CT(multi-detector row CT,MDCT)在腹股沟疝和股疝鉴别诊断中的价值。方法回顾性分析2012年10月1日至2013年10月31日期间笔者所在医院经临床证实为腹股沟区疝的260例患者的MDCT多平面重组(multi-planer reconstruction,MPR)图像资料,观察疝囊与腹股沟区解剖结构的关系。结果 260例患者中,腹股沟斜疝146例,直疝82例,股疝32例。146例斜疝患者(右侧75例,左侧60例,双侧11例,共157个疝囊)的疝囊于腹壁下动脉外侧经腹股沟深环进入腹股沟管,疝囊主要位于精索或子宫圆韧带前侧(103/157,65.6%)或前内侧(36/157,22.9%)。82例直疝患者(右侧39例,左侧34例,双侧9例,共91个疝囊)的疝囊位于腹壁下动脉内侧,主要位于精索内侧(70/91,76.9%)。斜疝及直疝的疝囊均走行于腹股沟韧带前上方。32例股疝患者(右侧17例,左侧15例,共32个疝囊)的疝囊均位于"影像学股三角"内。结论 MDCT的MPR手段能准确诊断腹股沟疝与股疝,且借助标志性解剖结构能进行可靠的鉴别诊断。
Objective To assess the significance of multi-detector row CT in differential diagnosis of the inguinal hernia and femoral hernia. Methods CT images which were reconstructed by multi-planer reconstruction （MPR） of 260 patients with inguinal hernia and femoral hernia who treated in our hospital form Oct. 1,2012 to Oct. 31,2013 were analyzed retrospectively, for exploring the relationship between sac and anatomic structure in the groin area. Results There were 146 patients with indirect hernia （75 in right, 60 in left, and 11 in bilateralism）, 82 patients with direct hernia （39 in right, 34 in left, and 9 in bilateralism）, and 32 patients with femoral hernia （17 in right and 15 in left）. The 157 sacs of patients with indirect hernia originated lateral to the inferior epigastric artery, entered the inguinal canal and through the deep ring, which mainly located anterior （103/157, 65.6%） or anteromedial （36/157, 22.9%） to the spermatic cord or round ligament. The 91 sacs of patients with direct hernia originated medial to the inferior epigastric artery, and mainly located medial to the spermatic cord （70/91, 76.9%）, Sacs of both indirect hernia and direct hernia located anterosuperior to the inguinal ligament. The 32 sacs of patients with femoral hernia located posterior to the inguinal ligament and inside the ＂radiological femoral triangle＂ of coronal views. Conclusions The MPR images available from multi-detector row CT permit the accurate diagnosis of groin hernias. By using simple anatomical criteria, direct hernia, indirect hernia, and femoral hernia can be reliably distinguished.
出处
《中国普外基础与临床杂志》
CAS
2013年第12期1424-1427,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
腹股沟疝
股疝
多排螺旋CT
鉴别诊断
Inguinalhemia
Femoralhemia
Multi-detectorrowCT
Differentialdiagnosis
