發(fā)布時間：2018-05-26 19:07

  本文選題：腸梗阻 + 缺血��； 參考：《中國醫(yī)學(xué)影像學(xué)雜志》2017年01期

【摘要】：目的評估采用CT增強(qiáng)掃描測量感興趣區(qū)(ROI)最大密度值的方法量化腸梗阻患者腸壁缺血程度的可行性。資料與方法選取160例經(jīng)CT增強(qiáng)掃描診斷為小腸梗阻的患者,回顧性分析所有患者的影像學(xué)資料,分別采用傳統(tǒng)的CT視覺評價法及測量ROI最大密度法進(jìn)行評測。CT視覺評價法采用積分的方式按照腸壁缺血程度分為5類;測量ROI最大密度法采用CT工作站提供的條形直方圖來量化腸壁強(qiáng)化程度。所得結(jié)果分別與臨床手術(shù)及病理結(jié)果進(jìn)行對比,計算2種方法對小腸缺血的敏感度、特異度、陽性預(yù)測值、陰性預(yù)測值及準(zhǔn)確度,并進(jìn)行對比分析。結(jié)果 CT視覺評價法2分對小腸缺血的敏感度、特異度、陽性和陰性預(yù)測值及準(zhǔn)確度分別為96.7%、72.9%、82.1%、94.4%及86.2%。測量ROI最大密度法中平掃及增強(qiáng)掃描ROI最大密度差值15 HU對小腸缺血的敏感度、特異度、陽性和陰性預(yù)測值及準(zhǔn)確度分別為68.8%、100.0%、100.0%、71.4%及82.5%。用測量受試者工作特性曲線下面積(AUC)的方法評價,測量ROI最大密度法中平掃及增強(qiáng)掃描ROI最大密度差值15 HU其AUC為0.995,視覺評價法2分其AUC為0.908,前者對小腸缺血的檢出有更高的準(zhǔn)確性。結(jié)論 ROI最大密度法可量化小腸壁的強(qiáng)化程度,與病理結(jié)果有良好的相關(guān)性,是診斷腸缺血可靠、有用的的途徑。
[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.
【作者單位】： 華北理工大學(xué)附屬醫(yī)院CT室;
【基金】：河北省醫(yī)學(xué)科學(xué)研究課題(河北省星火計劃,20150503) 河北聯(lián)合大學(xué)科學(xué)研究基金項目資助(河北省星火計劃,z201438)
【分類號】：R574.2;R816.5

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