分析腹股沟斜疝、直疝及股疝多排螺旋CT影像学特点及鉴别价值。

回顾性分析2018年1月至2020年1月，万宁市人民医院收治的腹股沟斜疝、直疝及股疝患者共120例，总结三种疝多排螺旋CT影像学特点及鉴别要点。

多排螺旋CT诊断斜疝灵敏度、特异度及准确率分别为95.24%、95.83%、95.45%；诊断直疝分别为92.86%、96.15%、95.45%；诊断股疝分别为100.00%、94.64%、95.45%；斜疝位于耻骨结节前内侧比例高于直疝、股疝（P<0.05）；直疝位于耻骨结节前外侧、检出新月征比例高于斜疝、股疝（P<0.05）；股疝位于耻骨结节后外侧比例、股三角填塞征检出率高于直疝、斜疝（P<0.05）；斜疝肠系膜内容物所占比例高于直疝、股疝（P<0.05），直疝膀胱内容物所占比例高于斜疝、股疝（P<0.05），直疝、股疝脂肪内容物所占比例高于斜疝（P<0.05），直疝、股疝发生肠梗阻所占比例高于斜疝（P<0.05）；斜疝腹股沟内环扩大所占比例高于直疝与股疝（P<0.05）。

腹股沟斜疝、直疝、股疝均存在特异性多排螺旋CT影像学征象；多排螺旋CT对鉴别斜疝、直疝、股疝均有较高价值，可清晰显示疝囊与腹股沟区解剖特点、疝内容物特点及并发症判断，有助于指导疝类型鉴别及手术方式的确立。

To analyze the imaging features and differential diagnosis value of multi-slice spiral CT (MSCT) for indirect inguinal hernia, direct hernia and femoral hernia.

A total of 120 patients with inguinal hernia, direct hernia and femoral hernia who were admitted to Wanning people's hospital from January 2018 to January 2020 were retrospectively collected. The imaging features and identification key points of MSCT for the three types of hernia were summarized.

The sensitivity, specificity and accuracy of MSCT in diagnosis of indirect inguinal hernia, direct hernia and femoral hernia were (95.24%, 95.83%, 95.45%), (92.86%, 96.15%, 95.45%) and (100.00%, 94.64%, 95.45%), respectively. The ratio of indirect hernia located at medial anterior pubic tubercle was higher than that of direct hernia and femoral hernia (P<0.05). The ratio of direct hernia located at lateral anterior pubic tubercle and detection rate of crescent sign were higher than those of indirect hernia and femoral hernia (P<0.05). The ratio of femoral hernias located at posterolateral pubic tubercle and the detection rate of femoral triangle packing sign were higher than those of direct hernia and indirect hernia (P<0.05). The ratios of mesenteric contents in indirect hernia were higher than those in direct hernia and femoral hernia (P<0.05). The ratios of bladder contents in direct hernia were higher than those in indirect hernia and femoral hernia (P<0.05). The ratios of fat contents in direct hernia and femoral hernia were higher than those in indirect hernia (P<0.05). The ratio of intestinal obstruction in direct hernia and femoral hernia was higher than that in indirect hernia (P<0.05). The ratio of enlarged inguinal inner circle in indirect hernia was higher than that in direct hernia and femoral hernia (P<0.05).

There are specific MSCT imaging signs in indirect inguinal hernia, direct hernia and femoral hernia. MSCT is of high value in identifying the three types of hernia, and it can clearly display the anatomical features of hernia sac and inguinal region, features of hernia contents and complications determining, and can help guide the identification of hernia types and determining surgical methods.