CT在检测和监测膈下枣核的效用：临床病例与实验的回顾性横断面研究

Utility of CT in detecting and monitoring subphrenic jujube pits: a retrospective cross-sectional study of clinical cases and experiments.

作者信息

Hao Luwen, Wang Qiuxia, Hu Xuemei, Li Zhen, Hu Daoyu, Shen Yaqi

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Quant Imaging Med Surg. 2022 Nov;12(11):5114-5128. doi: 10.21037/qims-22-53.

DOI:10.21037/qims-22-53

PMID:36330181

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9622438/

Abstract

BACKGROUND

Subphrenic jujube foreign body can cause perforation, abscess, peritonitis and other complications. Computed tomography (CT) is considered to be a sensitive tool for small or faintly opaque foreign body (e.g., jujube pits, toothpicks, fish bones, acrylics and plastics) detection. The present study aimed to investigate the clinical and imaging features of subphrenic jujube pits and explore the potential of CT for detecting and monitoring subphrenic jujube pits.

METHODS

Patients with subphrenic jujube pits who were treated at our institution were retrospectively reviewed along with published studies. A total of 10 types of commercially available jujube pits were analyzed with CT, then another 40 jujube pits (≥2.5 cm) were randomly selected and soaked in a series of solutions to mimic the gastrointestinal tract processes, following which CT was performed at serial time points with conventional and dual-energy protocols.

RESULTS

All jujube pits could be detected by CT, presenting spindle-shape high-density. The length of jujube pits based on clinical cases and that of the commercially available types were 1.38 to 3.50 cm and 1.35 to 3.95 cm, respectively. After analysis, the mean attenuation values derived from the clinical cases [77.67 Hounsfield unit (HU), range: -89.92 to 153.13 HU, SD 64.70 HU] were higher than those of the 10 commercially available types of jujube pits in boiled (73.57 HU, range: 2.29 to 94.96 HU, SD 20.48 HU) and raw state (-274.28 HU, range: -400.12 to -168.12 HU, SD 72.75 HU); statistically significant differences were found in mean attenuation values between raw jujube pits and boiled jujube pits (P<0.05). After soaking, the radiodensity of raw jujube pits showed an upward trend over immersion time, and water (-hydroxyapatite) overlay images enhanced the visualization of jujube pit water content as the percentage of blue area increased over time.

CONCLUSIONS

CT plays an important role in evaluating and tracing subphrenic jujube pits.

摘要

背景

膈下枣核异物可导致穿孔、脓肿、腹膜炎等并发症。计算机断层扫描（CT）被认为是检测小的或轻度不透光异物（如枣核、牙签、鱼骨、丙烯酸和塑料）的敏感工具。本研究旨在探讨膈下枣核的临床和影像学特征，并探索CT检测和监测膈下枣核的潜力。

方法

回顾性分析在本机构接受治疗的膈下枣核患者以及已发表的研究。用CT分析了10种市售枣核，然后随机选择另外40个枣核（≥2.5 cm），将其浸泡在一系列溶液中以模拟胃肠道过程，之后在连续时间点采用传统和双能方案进行CT检查。

结果

所有枣核均可被CT检测到，呈纺锤形高密度影。基于临床病例的枣核长度和市售类型的枣核长度分别为1.38至3.50 cm和1.35至3.95 cm。分析后发现，临床病例中枣核的平均衰减值[77.67亨氏单位（HU），范围：-89.92至153.13 HU，标准差64.70 HU]高于10种市售枣核在煮熟状态（73.57 HU，范围：2.29至94.96 HU，标准差20.48 HU）和生状态（-274.28 HU，范围：-400.12至-168.12 HU，标准差72.75 HU）下的平均衰减值；生枣核和煮熟枣核的平均衰减值存在统计学显著差异（P<0.05）。浸泡后，生枣核的放射密度随浸泡时间呈上升趋势，水（-羟基磷灰石）叠加图像增强了枣核含水量的可视化，因为蓝色区域的百分比随时间增加。