分析多排螺旋CT（MSCT）多平面重建（MPR）技术在腹股沟疝鉴别及嵌顿疝预测中的应用。

回顾性分析2017年1月至2022年12月南京医科大学附属苏州医院经手术证实的110例腹股沟疝术前MSCT图像，其中斜疝49例、直疝36例及股疝25例。观察冠状位及斜冠状位MPR图像中腹股沟韧带、腹壁下动脉、直疝三角、股三角的显示情况，以及疝内容物、疝囊颈比、特殊征象等。

腹股沟韧带在冠状位MPR和斜冠状位MPR图像中完全显示分别为24例（20.7%）和63例（54.3%），部分显示分别为43例（37.1%）和33例（28.4%），不显示分别为49例（42.2%）和20例（17.2%），斜冠状位MPR对腹股沟韧带的完全显示率优于冠状位MPR，差异有统计学意义（P<0.05）。三种类型疝内容物包括小肠、积液、肠系膜、脂肪等。其中，股疝疝囊内出现积液的概率高于斜疝和直疝（P<0.05），斜疝疝囊内出现脂肪的概率低于直疝和股疝（P<0.05）。侧新月征和直疝三角填塞征在直疝中的发生率高于斜疝和股疝（P<0.05），股三角填塞征在股疝中的发生率高于斜疝和直疝（P<0.05）。7个（7/51，13.7%）斜疝疝囊发生嵌顿，6个（6/39，15.4%）直疝疝囊发生嵌顿，19个（19/26，73.1%）股疝疝囊发生嵌顿，股疝嵌顿发生率高于斜疝和直疝（P<0.05）。嵌顿性斜疝和直疝中，疝囊出现积液的概率高于非嵌顿性疝（P<0.05）。嵌顿性和非嵌顿性斜疝的疝囊颈比中位数分别为3.1和1.3，差异有统计学意义（P<0.05），当临界值为2.3时，受试者工作特征曲线下面积（AUC）为0.97；嵌顿性和非嵌顿性直疝的疝囊颈比中位数分别为4.5和2.8，差异存在统计学意义（P<0.05），当临界值为3.9时，AUC为0.98；嵌顿性和非嵌顿性股疝的疝囊颈比分别为3.8和2.3，差异有统计学意义（P=0.02），当临界值为3.2时，AUC为0.84。

MSCT MPR技术有助于腹股沟区解剖结构的显示及腹股沟疝类型的判断，疝囊内出现积液、疝囊颈比增大对嵌顿疝具有提示作用。

To analyze the value of the multi-planar reconstruction (MPR) technique of multi-slice spiral computed tomography (MSCT) in the identification of inguinal hernia and prediction of incarcerated hernia.

Retrospectively analyze the preoperative MSCT images of 110 cases of surgically confirmed inguinal hernia at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2017 to December 2022, including 49 cases of indirect inguinal hernia, 36 cases of direct inguinal hernia, and 25 cases of femoral hernia. To observe the following targets in coronal and oblique coronal MPR images: inguinal ligament, inferior epigastric artery, Hesselbach's triangle, femoral triangle, hernia contents, the ratio of the hernia sac to the neck and special CT signs.

In coronal MPR and oblique coronal MPR images, the inguinal ligament was completely displayed in 24 (20.7%) and 63 (54.3%) cases respectively, partially displayed in 43 (37.1%) and 33 (28.4%) cases respectively, and not displayed in 49 (42.2%) and 20 (17.2%) cases respectively. The complete display rate of the inguinal ligament in oblique coronal MPR was better than that in coronal MPR, and the difference was statistically significant (P<0.05). The contents of three types of inguinal hernia included small intestine, fluid, mesentery, fat, etc. The incidence of fluid accumulation in the femoral hernia sac was higher than that in indirect inguinal hernias and direct inguinal hernias (P<0.05). The incidence of fat in the indirect inguinal hernia sac was lower than that in direct inguinal hernias and femoral hernias (P<0.05). The lateral crescent sign and Hesselbach's triangle filling sign only appeared in direct inguinal hernias (P<0.05). The femoral triangle filling sign only appeared in femoral hernia (P<0.05). Seven (7/51, 13.7%) indirect inguinal hernia sacs were incarcerated, 6 (6/39, 15.4%) direct inguinal hernia sacs incarcerated, and 19 (19/26, 73.1%) femoral hernia sacs were incarcerated. The incidence of incarceration in femoral hernia was higher than that in indirect inguinal hernias and direct inguinal hernias (P<0.05). The incidence of fluid accumulation in the hernia sac of incarcerated indirect hernia and direct hernia was higher than that in non-incarcerated hernia (P<0.05). The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated indirect inguinal hernias was 3.1 and 1.3, respectively. The differences between the two groups were statistically significant (P<0.05). When the critical value was 2.3, the area under the receiver operating characteristic curve (AUC) was 0.97. The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated direct inguinal hernias was 4.5 and 2.8, respectively. The differences between the two groups were statistically significant (P=0.03). When the critical value was 3.9, AUC was 0.98. The median of the ratio of the hernia sac to the neck in incarcerated and non-incarcerated femoral hernias was 3.8 and 2.3, respectively. The differences between the two groups were statistically significant (P<0.05). When the critical value was 3.2, the AUC was 0.84.

MSCT MPR technology is advantageous in displaying the anatomical structure of the inguinal area and determining the type of inguinal hernia. The presence of fluid accumulation in the hernia sac and an increase in the ratio of the hernia sac to the neck can provide clues for incarcerated hernia.