摘要
目的:探讨计算机X线断层扫描(CT)检查诊断食管癌术后吻合口瘘的应用价值。方法:回顾性选取我院收治的100例疑似食管癌术后吻合口瘘患者的临床资料作为研究对象,时间为2015年1月至2021年11月。所有疑似患者均行胸部CT、上消化道造影检查,以临床检查为金标准。记录并比较胸部CT、上消化道造影检查对吻合口瘘的检出情况,胸部CT诊断吻合口瘘与无吻合口瘘的影像学特征及胸部CT、上消化道造影检查的诊断效能(特异度、灵敏度、准确度、阳性预测值、阴性预测值)。结果:100例疑似食管癌术后吻合口瘘患者经临床检查后,确诊为吻合口瘘73例,无吻合口瘘27例;经胸部CT检查后,确诊为吻合口瘘82例,无吻合口瘘18例,其中仅有69例为真实吻合口瘘患者;经上消化道造影检查后,确诊为吻合口瘘59例,无吻合口瘘41例,其中仅有57例为真实吻合口瘘患者。CT检查显示,吻合口瘘与无吻合口瘘患者在对比剂外漏、瘘口显示、纵隔气、积聚集征象方面差异有统计学意义;吻合口瘘患者纵隔内单纯积气最大径平均值大于无吻合口瘘患者,差异有统计学意义(P<0.05);吻合口瘘与无吻合口瘘患者在胸腔气、积聚集、胸腔单纯积液、颈前、胸壁积气征象方面差异无统计学差异(P>0.05)。与上消化道造影检查相比,胸部CT检查诊断吻合口瘘的特异度较低、灵敏度较高,差异均有统计学意义(P<0.05);而两种检查方式的准确度、阴性预测值、阳性预测值无统计学意义(P>0.05)。结论:对比剂外漏、瘘口显示、纵隔气、积聚集均为CT诊断食管癌术后吻合口瘘较特异的影像征象,食管癌术后吻合口瘘患者行胸部CT诊断具有高灵敏度、低特异度,故而其适用于怀疑吻合口瘘而不宜行上消化道造影者。
Objective:To investigate the application value of computed tomography(CT)in the diagnosis of postoperative anastomotic leakage of esophageal cancer.Methods:The clinical data of 100 patients with suspected esophageal cancer postoperative anastomotic leakage treated in our hospital were retrospectively selected as the research objects.The selection period is from January 2015 to November 2021.All suspected patients underwent chest CT and digestive angiography,with clinical examination as the gold standard.To record and compare the detection of anastomotic leakage by chest CT and digestive angiography,the imaging features of chest CT in the diagnosis of anastomotic leakage and those without anastomotic leakage,and the diagnostic efficacy of chest CT and digestive angiography(specificity,sensitivity,accuracy,positive predictive value,negative predictive value).Results:After clinical examination of 100 patients with suspected esophageal cancer postoperative anastomotic leakage,73 cases were diagnosed as anastomotic leakage,and 27 cases were without anastomotic leakage.After chest CT examination,82 cases were diagnosed as anastomotic leakage without anastomotic stoma.There were 18 cases of anastomotic leakage,of which only 69 cases were real anastomotic leakage patients;after digestive angiography,59 cases were diagnosed as anastomotic leakage,and 41 cases were without anastomotic leakage,of which only 57 cases were real anastomotic leakage patients.CT examination showed that there were statistically significant differences between the patients with anastomotic leakage and those without anastomotic leakage in contrast medium leakage,fistula display,mediastinal air,and accumulation signs;greater than that of patients without anastomotic leakage,and the difference was statistically significant(all P<0.05);There was no statistical difference between the patients with anastomotic leakage and those without anastomotic leakage in pleural gas,accumulation,simple pleural effusion,anterior neck and chest wall gas signs(all P>0.
作者
高子健
苗新中
Gao Zi-jian;Miao Xin-zhong(Department of Imaging,The Third Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)
出处
《影像技术》
CAS
2022年第3期51-56,共6页
Image Technology
