评估CT多平面重建（MPR）技术在腹股沟疝术前类型鉴别及嵌顿风险预测中的临床应用价值，为优化临床术前评估流程提供参考。

本研究为单中心回顾性诊断准确性研究，选取2023年1月至2025年4月中国人民解放军陆军第七十三集团军医院经手术证实的102例腹股沟疝患者（共109个疝囊），所有患者术前均行多层螺旋CT（MSCT）平扫及MPR重建（冠状位、斜冠状位、矢状位）检查。分析不同重建平面对腹股沟区关键解剖结构的显示效果，提取特征性影像学征象，测量疝囊颈比（疝囊最大宽度与疝囊颈宽度的比值），以手术结果为金标准，采用受试者操作特征（ROC）曲线分析该技术的分型诊断效能及嵌顿风险预测价值。

斜冠状位MPR重建对腹股沟韧带的完全显示率（56.88%）显著高于冠状位（21.10%），不显示率（14.68%）显著低于冠状位（40.37%）（P<0.05）。"侧新月征""直疝三角填塞征"鉴别直疝与斜疝的AUC值分别为0.812、0.843，"股三角填塞征"鉴别股疝与其他类型疝的AUC值为0.831（P<0.05）。股疝嵌顿率（72.00%，18/25）显著高于斜疝（14.58%，7/48）和直疝（16.67%，6/36）（χ²=36.241，P<0.001）。疝囊颈比预测斜疝、直疝、股疝嵌顿的最佳临界值分别为2.40、3.70、3.30，AUC值依次为0.852、0.876、0.791。

CT MPR技术能清晰显示腹股沟区解剖结构，其特征性征象可精准鉴别不同类型腹股沟疝，疝囊颈比可有效量化预测嵌顿风险，为临床制订个体化治疗方案提供可靠依据。

To evaluate the clinical application value of CT multiplanar reconstruction (MPR) technology in the preoperative differentiation of inguinal hernia types and prediction of incarceration risk, and to provide a reference for optimizing the clinical preoperative evaluation process.

This was a single-center retrospective diagnostic accuracy study. A total of 102 patients with inguinal hernia (involving 109 hernia sacs) confirmed by surgery at the 73rd Group Army Hospital of the Chinese People's Liberation Army Army from January 2023 to April 2025 were included. All patients underwent preoperative multi-slice spiral CT (MSCT) plain scan and MPR (coronal, oblique coronal, and sagittal planes). The display effects of different reconstruction planes on key anatomical structures in the inguinal region were analyzed, characteristic imaging signs were identified, and the hernia sac neck ratio (the ratio of the maximum width of the hernia sac to the width of the hernia sac neck) was measured. Using surgical findings as the gold standard, receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance for hernia classification and the predictive value for incarceration risk.

The complete visualization rate of the inguinal ligament using oblique coronal MPR was significantly higher than that using coronal reconstruction (56.88% vs. 21.10%), while the non-visualization rate (14.68%) was significantly lower than that of coronal reconstruction (40.37%) (P<0.05). The area under the curve (AUC) values of the "lateral crescent sign" and the "direct inguinal hernia triangle filling sign" for differentiating direct from indirect inguinal hernia were 0.812 and 0.843, respectively, while the AUC value of the "femoral triangle filling sign" for distinguishing femoral hernia from other types of hernia was 0.831 (P<0.05). The incarceration rate of femoral hernia (72.00%, 18/25) was significantly higher than that of indirect hernia (14.58%, 7/48) and direct hernia (16.67%, 6/36) (χ²=36.241, P<0.001). The optimal cutoff values of the hernia sac neck ratio for predicting incarceration in indirect, direct, and femoral hernias were 2.40, 3.70, and 3.30, respectively, with corresponding AUC values of 0.852, 0.876, and 0.791.

CT MPR technology can clearly delineate the anatomical structures of the inguinal region. Its characteristic imaging signs enable accurate differentiation of various types of inguinal hernias, and the hernia sac neck ratio can effectively quantify and predict the risk of incarceration, thereby providing a reliable basis for individualized clinical treatment planning.