医源性膈疝MSCT多平面重组表现

发布时间：2018-02-05 19:50

本文关键词： 食管裂孔膈疝医源性体层摄影术 X线计算机　出处：《临床放射学杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的分析食管癌术后继发医源性膈疝(IDH)的MSCT多平面重组(MPR)表现,探讨其诊断价值。方法回顾性分析2010年1月至2014年3月间食管癌术后继发IDH 16例。将其CT号随机混编入其他50例食管癌术后无食管裂孔(EH)扩大患者队列,由2名不知研究目的从事腹部影像诊断的高年资医师分别就横断位和MPR图像进行判断。对不同医师、不同方法判断结果及影像表现差异采用χ2检验。结果 16例IDH中3例局限性于EH,横断位2例呈假"肠套叠"征,1例呈肠扭转表现;MPR直观显示肠管挤入EH顶压胸腔胃呈"壁贴壁征"。13例超出EH范围,横断位表现为胸腔内肠管于各方向汇聚于EH处胸腔胃,其中,前外、后外及前后外侧分别为9例、5例和2例,前外侧明显多于前后外侧(χ2=6.79,P0.05),2例并肠系膜扭转;MPR直观显示胸腔内管肠及其系膜血管通过EH与腹腔相应结构连通。由2名医师横断位提示IGH诊断分别为3例和4例,MPR全部提示IDH诊断,均显著高于横断位(χ2=21.89,19.20,P值均0.05)。结论食管癌术后继发IDH横断位表现隐匿,仔细观察并及时辅以MPR,对诊断具有重要意义。
[Abstract]:Objective to analyze the MSCT multiplanar recombination of iatrogenic diaphragmatic hernia (IDH) in postoperative esophageal carcinoma patients. To evaluate the diagnostic value of IDH in patients with esophageal cancer from January 2010 to March 2014. Methods from January 2010 to March 2014, the secondary IDH of esophageal carcinoma was analyzed retrospectively. In 16 cases, CT numbers were randomly mixed into other 50 cases of esophageal cancer without esophageal hiatus (. EH) expanded the patient cohort. Two senior physicians who were engaged in abdominal imaging diagnosis were evaluated on transverse and MPR images respectively. Results among the 16 cases of IDH, 3 cases were localized in IDH, 2 cases in transverse position showed pseudo-intussusception sign and 1 case showed intestinal torsion. MPR showed that the intrathoracic stomach was "wall sticking sign". 13 cases were beyond the range of EH. The transverse position showed that the intrathoracic intestinal tube converged in all directions in the thoracic stomach of EH, among which, anterior and outer. The numbers of anterolateral and anterolateral were 9 cases and 2 cases respectively. The anterolateral side was significantly more than the anterolateral side (蠂 2 6.79 P 0.05) with mesenteric torsion in 2 cases. MPR showed that the intrathoracic tube intestine and mesenteric vessels were connected with the corresponding structure of the abdominal cavity through EH. 3 cases and 4 cases of IGH were diagnosed by transverse position of 2 physicians, all of which suggested the diagnosis of IDH. All of them were significantly higher than those in transverse position (蠂 ~ 2 + 21.89 ~ 19.20 P, P = 0.05). Conclusion the secondary IDH transection of esophageal carcinoma is concealed, and MPR is observed carefully and supplemented in time. It is of great significance for diagnosis.
【作者单位】：江苏省海门市人民医院放射科;江苏省南通大学附属医院影像科;
【分类号】：R655.6;R816.5

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