十二指肠钝性损伤的MSCT诊断

发布时间：2018-11-28 14:00

【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。
[Abstract]:Objective: to investigate the MSCT diagnosis of duodenal blunt injury. Methods: the MSCT findings of 36 patients with duodenal blunt injury confirmed by operation or clinic were analyzed retrospectively. All patients were performed MSCT transection plain scan, plain scan combined with post-processing image for the duodenal obtuse injury double-blind reading. The detection rate of duodenal blunt injury by two methods was tested by 蠂 ~ 2 test by paired four-grid McNemar exact probability method. Results: 36 cases of duodenal blunt injury were located in duodenal bulb in 2 cases, descending part in 18 cases, horizontal part in 3 cases, ascending part in 3 cases, and descending and horizontal junction in 10 cases. The main manifestations of duodenal blunt injury in MSCT were thickening of duodenal wall, fat strip shadow of periduodenal membrane, hematoma of duodenal wall, retroperitoneal free gas shadow, retroperitoneal effusion and retroperitoneal hematoma. The detectable rate was 80.6%, 91.7% and 8.3%, 13.8% and 16.7%, respectively. The correct diagnosis rate of duodenal blunt injury by MSCT was 88.9% (32 / 36). There was significant difference between the two methods in the detection rate of duodenal blunt injury (P0. 031). Conclusion: the MSCT findings of duodenal blunt injury have some characteristics. According to MSCT and combined post-processing images, the diagnosis of duodenal blunt injury can be made more accurately, and the detection rate of duodenal blunt injury can be improved obviously by MSCT transection combined with post-processing image.
【作者单位】：浦东新区人民医院放射科;
【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)
【分类号】：R656.6;R816.5

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