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中华疝和腹壁外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 466 -470. doi: 10.3877/cma.j.issn.1674-392X.2021.05.006

临床论著

多层螺旋CT扫描与图像后处理在腹股沟疝术前分型的评估效能
王隽1,(), 宁飞龙1, 张颢1, 刘阳1, 权红光1, 严金明1   
  1. 1. 221009 江苏省,徐州市中医院普外科
  • 收稿日期:2021-01-05 出版日期:2021-10-14
  • 通信作者: 王隽

Efficiency analysis of multi-slice spiral CT scanning and image post-processing in preoperative classification of groin hernia patients

Jun Wang1,(), Feilong Ning1, Hao Zhang1, Yang Liu1, Hongguang Quan1, Jinming Yan1   

  1. 1. Department of General Surgery, Xuzhou Traditional Chinese Medicine Hospital, Xuzhou 221009, China
  • Received:2021-01-05 Published:2021-10-14
  • Corresponding author: Jun Wang
引用本文:

王隽, 宁飞龙, 张颢, 刘阳, 权红光, 严金明. 多层螺旋CT扫描与图像后处理在腹股沟疝术前分型的评估效能[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(05): 466-470.

Jun Wang, Feilong Ning, Hao Zhang, Yang Liu, Hongguang Quan, Jinming Yan. Efficiency analysis of multi-slice spiral CT scanning and image post-processing in preoperative classification of groin hernia patients[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(05): 466-470.

目的

探讨分析多层螺旋计算机断层扫描(MSCT)与图像后处理在腹股沟疝术前分型评估中的效能。

方法

回顾性分析2015年1月至2019年8月,徐州市中医院采用腹腔镜经腹腹膜前疝修补术(TAPP)治疗的腹股沟疝86例患者的临床资料,术前均采用MSCT与图像后处理检查,进行分型评估,统计不同分型患者的影像学表现特点及分型结果,并将腹腔镜术中所见分型作为标准,采用Kappa检验分析MSCT与图像后处理检查结果和腹腔镜术中所见结果的一致性。

结果

MSCT与图像后处理术前分型评估和腹腔镜术中分型结果:术前斜疝77例,Ⅰ型29例、Ⅱ型41例、Ⅲ型7例;术中Ⅰ型30例、Ⅱ型40例、Ⅲ型8例;术前直疝5例,Ⅳ型2例、Ⅴ型3例,术中Ⅳ型1例、Ⅴ型4例;术前马鞍疝Ⅵ型3例,术中Ⅵ型2例;术前股疝Ⅶ型1例,术中Ⅶ型1例。斜疝、直疝、马鞍疝和股疝患者MSCT与图像后处理术前分型结果与腹腔镜术中分型的符合率分别为93.48%、100%、79.43%、100%;MSCT与图像后处理腹股沟疝术前分型和腹腔镜术中分型一致性良好(Kappa=0.9106,P<0.05)。

结论

MSCT与图像后处理在腹股沟疝术前分型评估中效能高,与腔镜术中所见分型结果高度一致。

Objective

To explore and analyze the efficacy of multi-slice spiral computed tomography (MSCT) scanning and image post-processing in preoperative classification of groin hernia patients.

Methods

The clinical data of 86 cases of adult groin hernia treated by laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) in Xuzhou Traditional Chinese Medicine Hospital from January 2015 to August 2019 were retrospectively analyzed. MSCT and image post-processing were used to evaluate the classification before operation. The imaging features and classification results of patients with different types were counted, and the classification seen in laparoscopy was regarded as the standard. Kappa test was used to analyze the consistency between MSCT and image post-processing examination results and intraoperative findings.

Results

The results of MSCT and image post-processing examination before typing were 77 cases of indirect groin hernia, type Ⅰ in 29 cases, type Ⅱ in 41 cases, type Ⅲ in 7 cases, the results of laparoscopic typing were: type Ⅰ in 30 cases, type Ⅱ in 40 cases, type Ⅲ in 8 cases; The results of MSCT and image post-processing examination before typing were 5 cases of direct groin hernia, type Ⅳ in 2 cases, type Ⅴ in 3 cases, the results of laparoscopic typing were: type Ⅳ in 1 case, type Ⅴ in 4 cases; The results of MSCT and image post-processing examination before typing were 3 cases of groin saddle hernia, type Ⅵ in 3 cases, the results of laparoscopic typing were: type VI in 2 cases; The results of MSCT and image post-processing examination before typing were 1 case of femoral hernia (type Ⅶ), the results of laparoscopic typing were: type Ⅶ in 1 case. The coincidence rates of MSCT and image post-processing preoperative typing and laparoscopic typing were 93.48%, 100%, 79.43%, 100% for indirect groin hernia, direct groin hernia, groin saddle hernia and femoral hernia, respectively. According to Kappa test, MSCT had good consistency with preoperative and laparoscopic classification of indirect groin hernia, direct groin hernia, groin saddle hernia and femoral hernia after image processing (Kappa=0.9106, P<0.05).

Conclusion

MSCT and image post-processing are highly effective in evaluating preoperative classification of groin hernia patients by laparoscopy, and are highly consistent with the results of intraoperative classification.

表1 MSCT与图像后处理术前分型(斜疝和直疝)
表2 术中腔镜分型诊断结果(斜疝和直疝)
表3 MSCT与图像后处理术前分型和术中腔镜分型诊断结果统计
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