螺旋CT在常见急腹症病因诊断和处理中的价值(1)
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2010年3月25日
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[摘要] 目的:探讨螺旋CT在常见急腹症病因诊断和处理中的价值。方法:回顾性分析经手术或临床证实的120例常见急腹症的螺旋CT征象,比较螺旋CT检查前后的诊断、治疗方案、手术符合率。结果:120例常见急腹症的病因中,急性胰腺炎20例,肠梗阻24例,消化道穿孔10例,胆系疾病15例,泌尿系结石13例,急性阑尾炎8例,妇科疾病7例,创伤性疾病23例。在CT检查前,病因诊断正确70例(58.3%),经螺旋CT检查后病因诊断正确112例(93.3%),经CT确诊后,使临床治疗方案发生改变25例(20.8%)。结论:螺旋CT是一种快捷、简便、有效的影像学检查方法,对常见急腹症的病因诊断具有重要价值,可提高临床正确处理急腹症的能力。
[关键词] 急腹症;体层摄影术;X线计算机
[中图分类号] R445.3 [文献标识码]C [文章编号]1674-4721(2010)03(c)-068-03
The value of spiral CT in the diagnosis and management of common acute abdomen
LIU Jiandong*,LI Jianguo,CHEN Li,REN Zhi
(Department of Radiology,Pengxi People′s Hospital of Sichuan Province, Pengxi 629100,China)
[Abstract] Objective:To evaluate the value of spiral CT in the diagnosis and management of common acute abdomen.Methods:The CT findings of 120 cases with common acute abdomen confirmed by surgical findings or clinical follow-up were analyzed retrospectively.Diagnosis concordance,treatment,and operation concordance were compared.Results:The etiology resulted in common acute abdomen in 120 cases included acute pancreatitis 20 cases,intestinal obstruction 24 cases, digestive tract perforation 10 cases, biliary disease 15 cases, urinary calculi 13 cases, acute appendicitis 8 cases, gynecologic disease 7 cases, traumatic disease 23 cases. The diagnosis of the causes of acute abdomen in 70 cases (58.3%) by clinic and in 112 cases (93.3%) by SCT scan was correct. After sure diagnosis by CT scan,the clinical management was changed in 25 cases (20.8%). Conclusion: Spiral CT is a rapid, simple and effective imaging technique.It plays an important role in the diagnosis of common acute abdomen and help surgeons to improve the ability to correctly manage acute abdomen.
[Key words] Acute abdomen;Tomography;X-ray computed
急腹症是腹部急性疾病的总称,它是以短时间内出现剧烈腹痛为临床表现的一类疾病,其病因复杂,临床起病急,变化快,病情危重,部分疾病在短时间内就可能危及患者生命,因此,迅速采用适当的检查方法,及时准确地对急腹症病因作出诊断十分重要。本文回顾性分析本院120例经手术及临床证实的常见急腹症患者资料,探讨螺旋CT在急腹症病因诊断和处理中的价值。
1 资料与方法
1.1 一般资料
选择2006年1月～2009年12月本院手术及临床证实的急腹症患者120例,其中,男性72例,女性48例,年龄8～73岁,平均41岁。所有患者均有不同程度的急性腹痛症状,部分伴有发热、腹胀、呕吐及肛门停止排气、排便等。手术、病理证实78例,保守治疗42例。
1.2 检查方法
使用东芝Asteion/VF螺旋CT机,扫描层厚及间隔均为10 mm,螺距1.0,120 kV,200 mAs,患者取仰卧位,吸气末屏气扫描,扫描范围自膈面至耻骨联合,部分感兴趣区作层厚5 mm、层距5 mm薄层扫描。静脉增强CT18例,扫描时静脉团注60%非离子型碘对比剂100 ml,流速2～3 ml/s,注射对比剂后行双期增强扫描 ......
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