摘要
目的:探讨十二指肠钝性损伤的MSCT诊断。方法:回顾性分析经手术或临床证实的36例十二指肠钝性损伤患者的MSCT表现。所有患者均行MSCT横断平扫,分别就平扫、平扫联合后处理图像两种方法对是否十二指肠钝性损伤进行双盲读片,两种方法对十二指肠钝性损伤的检出率运用配对四格表McNemar确切概率法χ2检验。结果:36例十二指肠钝性损伤分别位于十二指肠球部2例,降部18例,水平部3例,升部3例,降部和水平部交界区10例。十二指肠钝性损伤的MSCT主要表现为十二指肠肠壁增厚、十二指肠周围膜脂肪条索影、十二指肠肠壁血肿、腹膜后游离气体影、腹膜后积液和腹膜后血肿,其检出率分别为80.6%、91.7%、8.3%、13.8%、30.6%和16.7%。本组综合运用MSCT征象对十二指肠钝性损伤的正确诊断率达88.9%(32/36)。两种方法对十二指肠钝性损伤的检出率有显著性差异(P=0.031)。结论:十二指肠钝性损伤的MSCT表现具有一定特点,根据MSCT及联合后处理图像可对十二指肠钝性损伤做出较为准确的诊断。MSCT横断平扫联合后处理图像明显提高对十二指肠钝性损伤的检出率。
Objective：To investigate the diagnosis value of MSCT（multi-slice CT）in blunt duodenal injury.Methods：The MSCT appearances of 36 cases with BDIs（blunt duodenal injuries）confirmed by surgery and（or）clinical findings were analyzed retrospectively.All patients underwent MSCT plain scanning of whole abdomen.Two experienced radiologists blinded to the clinical diagnosis,reached a diagnosis from the MSCT findings by two ways of plain scanning and plain scanning combined with post-processing MSCT images.The detection rates of BDIs were compared by two-related-samples McNemar exact probability chi-square test.Results：Thirty-six cases of BDIs were located at the 1st（n=2）,2nd（n=18）,3rd（n=3）and 4th（n=3）portion of duodenum,respectively,and the other ten cases located at the junction of the 2nd and 3rd portion of duodenum.The MSCT findings of BDIs mainly consisted of duodenal wall thickening,duodenal mesenteric streaking,duodenal wall hematoma,free retroperitoneal air,free retroperitoneal fluid and retroperitoneal hematoma.Their detectable rates were 80.6%,91.7%,8.3%,13.8%,30.6% and 16.7% respectively.The accuracy in diagnosis of BDIs with MSCT was 88.9%（32/36）in our study.There was significant statistical difference in detection rate of BDI between plain scanning and plain scanning with postprocessing technique（P=0.031）.Conclusion：MSCT manifestations of BDIs have certain characteristics.A more accurate diagnosis of BDIs can be reached using the plain scanning with post-processing MSCT images.The detection rate of BDIs is increased obviously by the way of plain scanning combined with post-processing MSCT images.
出处
《放射学实践》
北大核心
2015年第6期655-659,共5页
Radiologic Practice
基金
浦东新区卫生系统领先人才培养基金(PWR12010-02)
浦东新区人民医院重点学科群基金(PRxkq2013-03)
