测量感兴趣区最大密度对肠梗阻合并肠缺血的诊断价值

发布时间：2018-05-26 19:07

本文选题：肠梗阻 + 缺血　；参考：《中国医学影像学杂志》2017年01期

【摘要】：目的评估采用CT增强扫描测量感兴趣区(ROI)最大密度值的方法量化肠梗阻患者肠壁缺血程度的可行性。资料与方法选取160例经CT增强扫描诊断为小肠梗阻的患者,回顾性分析所有患者的影像学资料,分别采用传统的CT视觉评价法及测量ROI最大密度法进行评测。CT视觉评价法采用积分的方式按照肠壁缺血程度分为5类;测量ROI最大密度法采用CT工作站提供的条形直方图来量化肠壁强化程度。所得结果分别与临床手术及病理结果进行对比,计算2种方法对小肠缺血的敏感度、特异度、阳性预测值、阴性预测值及准确度,并进行对比分析。结果 CT视觉评价法2分对小肠缺血的敏感度、特异度、阳性和阴性预测值及准确度分别为96.7%、72.9%、82.1%、94.4%及86.2%。测量ROI最大密度法中平扫及增强扫描ROI最大密度差值15 HU对小肠缺血的敏感度、特异度、阳性和阴性预测值及准确度分别为68.8%、100.0%、100.0%、71.4%及82.5%。用测量受试者工作特性曲线下面积(AUC)的方法评价,测量ROI最大密度法中平扫及增强扫描ROI最大密度差值15 HU其AUC为0.995,视觉评价法2分其AUC为0.908,前者对小肠缺血的检出有更高的准确性。结论 ROI最大密度法可量化小肠壁的强化程度,与病理结果有良好的相关性,是诊断肠缺血可靠、有用的的途径。
[Abstract]:Objective to evaluate the feasibility of measuring the maximum density of ROI by CT enhanced scanning in patients with intestinal obstruction. Materials and methods the imaging data of 160 patients with small bowel obstruction diagnosed by CT enhanced scanning were retrospectively analyzed. The traditional method of CT visual evaluation and the method of measuring the maximum density of ROI were used to evaluate. The method of CT visual evaluation was divided into 5 categories according to the degree of intestinal ischemia. The maximum density of ROI was measured by the bar histogram provided by CT workstation to quantify the degree of intestinal wall enhancement. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two methods for intestinal ischemia were calculated and analyzed. Results the sensitivity, specificity, positive and negative predictive value and accuracy of CT visual evaluation for intestinal ischemia were 96.72.9% and 82.4% and 86.2%, respectively. The sensitivity, specificity, positive and negative predictive value and accuracy of ROI maximum density difference of 15 Hu in ROI maximum density method were 68.8% and 100.0% and 82.5%, respectively. The method of measuring the area under the operating characteristic curve of subjects was used to evaluate, In the ROI maximum density method, the maximum density difference between plain scan and enhanced scanning ROI was 15 Hu, the AUC was 0.995, and the AUC of the visual evaluation method was 0.908. The former had higher accuracy in detecting small intestinal ischemia. Conclusion ROI maximum density method can quantify the enhancement degree of small intestine wall and has good correlation with pathological results. It is a reliable and useful way to diagnose intestinal ischemia.
【作者单位】：华北理工大学附属医院CT室;
【基金】：河北省医学科学研究课题(河北省星火计划,20150503) 河北联合大学科学研究基金项目资助(河北省星火计划,z201438)
【分类号】：R574.2;R816.5

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