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多排螺旋计算机断层扫描在肠梗阻诊断中的作用

Role of Multi-Detector Computed Tomography in the Diagnosis of Intestinal Obstruction.

作者信息

Afzal Shaista, Ahmad Furqan, Farooq Fizza

机构信息

Diagnostic Radiology, Aga Khan University Hospital, Karachi, PAK.

出版信息

Cureus. 2023 Jan 13;15(1):e33730. doi: 10.7759/cureus.33730. eCollection 2023 Jan.

Abstract

INTRODUCTION

There is a need to identify patients whose small bowel obstruction (SBO) can resolve spontaneously so that unnecessary surgical interventions are avoided. This study aimed to evaluate the diagnostic accuracy of multi-detector computed tomography (MDCT) in intestinal obstruction and find out the presence, level, causes, and degree of intestinal obstruction taking intraoperative findings as gold standard.

METHODOLOGY

This cross-sectional study was conducted analyzing 147 patients that were referred from emergency with abdominal pain, abdominal distension, inability to pass flatus, and aged 18-70 years from both genders. Computed tomography (CT) examinations were done and findings like intestinal dilatation, evidence of mesenteric fat stranding, and area of transition between the dilated and collapsed loops were noted. The final report was made by the radiologist while the operative findings were reviewed from the operative notes written by operative surgeons of the same patient.

RESULTS

In a total of 147 patients, mean age was 52.38±16.01 years. There were 76 (51.70%) males and 71 (48.30%) females. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of multi-detector computed tomography scan in diagnosing intestinal obstruction, taking operative findings as gold standard, were 98.39%, 65.22%, 93.85%, 88.24%, and 93.20%, respectively.

CONCLUSION

The multi-detector CT can be used routinely as a prime modality for detecting intestinal obstruction which will result in proper and timely management for reducing the morbidity and mortality of these particular patients.

摘要

引言

有必要识别出小肠梗阻(SBO)能够自发缓解的患者,从而避免不必要的手术干预。本研究旨在以术中发现为金标准,评估多排螺旋计算机断层扫描(MDCT)在肠梗阻诊断中的准确性,并找出肠梗阻的存在、部位、病因及程度。

方法

本横断面研究分析了147例因腹痛、腹胀、无法排气而从急诊科转诊的患者,年龄在18至70岁之间,男女不限。进行了计算机断层扫描(CT)检查,并记录了肠扩张、肠系膜脂肪束征的证据以及扩张肠袢与塌陷肠袢之间的移行区等表现。最终报告由放射科医生出具,而手术结果则从同一患者手术医生所写的手术记录中进行回顾。

结果

总共147例患者,平均年龄为52.38±16.01岁。男性76例(51.70%),女性71例(48.30%)。以手术结果为金标准,多排螺旋计算机断层扫描在诊断肠梗阻方面的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为98.39%、65.22%、93.85%、88.24%和93.20%。

结论

多排螺旋CT可作为检测肠梗阻的常规主要方法,从而实现恰当及时的治疗,降低这些特定患者的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f8c/9922381/68776ea05b0c/cureus-0015-00000033730-i01.jpg

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