摘要:
目的:探讨小肠粪便征(SBFS)在小肠梗阻患者CT检查中的应用价值。方法:回顾性分析我院2017年2月至2019年2月期间76例小肠梗阻患者的影像学资料。所有患者均行256层CT增强检查,应用多种后处理成像方式分析获得病例的影像学资料。根据梗阻程度将病例分为轻度组、中度组及重度组。按梗阻的病因类型,分为粘连组、炎症组、肿瘤组、克罗恩病及疝气组。将每组中出现SBFS的病例归入其所在组阳性病例中,未出现SBFS的病例归入其所在组阴性病例中。详细记录每组阳性病例中SBFS的长径范围及其与梗阻移行带的关系。通过统计学分析,评估SBFS在不同分组中的差异。结果:选取的76例小肠梗阻患者中42例出现了SBFS,其中轻度组13例(17.1%)中出现SBFS 2例(15.4%);中度组25例(32.9%)中出现SBFS 16例(64.0%);重度组38例(50.0%)中出现SBFS 24例(63.2%)。选取的76例小肠梗阻患者中粘连组45例(59.2%)中出现SBFS 22例(48.9%);炎症组10例(13.2%)中出现SBFS6例(60.0%);肿瘤组8例(10.5%)中出现SBFS 5例(62.5%);克罗恩病组7例(9.2%)中出现SBFS 5例(71.4%);疝气组6例(7.9%)出现SBFS 4例(66.7%)。在各组阳性病例中,35例(83.3%)患者的SBFS能明确定位到梗阻移行带,其长轴范围约为4.5~22.1 cm,CT值范围约-215~9 HU。SBFS在中度组及重度组患者中出现率明显高于轻度组,其差异具有统计学意义(P<0.05)。SBFS在粘连组、炎症组、肿瘤组、克罗恩病组及疝气组出现的概率无明显差异,其差异不具备统计学意义(P>0.05)。结论:SBFS能快速准确定位小肠梗阻患者的梗阻部位,节约诊断时间,为临床进一步诊疗提供帮助。
Abstract:
Objective:To explore the value of small bowel feces sign(SBFS) in CT examination of patients with small bowel obstruction. Materials:76 consecutive patients with Small-bowel obstruction were prospectively evaluated from February 2017 to February 2019. They were performed by 256-slice CT enhanced scans, and then analyzed the patient's axial, coronal and sagittal imaging data. All patients were divided into mild, moderate, or high-grade groups according to the degree of obstruction. All patients were divided into adhesion, inflammation, tumor, Crohn's disease, and hernia groups according to the cause of the SBO. According to the presence or absence of the SBFS, the cases were differentiated positive and negative respectively. Each group of positive cases were depicted detailed in the location, size, relation to the transition zone of the SBFS. The cause of the obstruction was decided from surgical results or follow-up CT findings. Evaluate differences in SBFS in different groups by statistical analysis. Result:The SBFS was presented in 42 of 76 patients. 13 cases were the mild small intestinal obstruction, 25 cases were the moderate, and 38 cases were the high-grade. The SBFS presenting in mild, moderate, and high-grade SBO was 2, 16 and 24 respectively. The SBFS presenting in adhesion, inflammation, tumor, Crohn's disease, and hernia groups was 22, 10, 5, 5 and 4 respectively. Among the positive cases in each group, 35(83.3%) patients with SBFS were able to clearly locate the obstructed transition zone, with a long axis range of about 4.5~22.1 cm and a CT range of about-215 to 9 HU. Significant differences were found regarding the probability of SBFS presenting in the moderate and high-grade group than that in mild group(P<0.05). No significant differences were found regarding the probability of SBFS presenting in adhesion, inflammation, tumor, Crohn's disease, hernia groups(P>0.05). Conclusion:The presence of SBFS can locate transition zone in SBO patients fast and accurately, and to help clinical diagnosis and treatment.
百度学术
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