应用多层螺旋CT（MDCT）多平面重建（MPR）技术测量Ⅰ型食管裂孔疝（HH）患者食管裂孔的大小，探讨其与体重指数（BMI）的相关性。

回顾性收集2022年1月至2025年6月徐州医科大学附属医院手术证实的106例Ⅰ型HH患者，分析其临床及影像特点，利用MDCT MPR技术测量患者食管裂孔的表面积（HSA）、前后径（AP）及横径（TD），根据BMI分为正常组、超重组及肥胖组，评估BMI与HSA、AP、TD间的相关性。

3组患者间，BMI与HSA的F值为4.54，P值为0.013，效应值偏η²为0.08；BMI与AP的F值为4.43，P值为0.014，效应值偏η²为0.08；BMI与TD的F值为9.85，P值<0.001，效应值偏η²为0.16，提示BMI对食管裂孔的HSA、AP、TD具有中等至较大的效应规模；3组在性别、年龄、身高、收缩压、舒张压和空腹血糖上差异无统计学意义（P>0.05，偏η²<0.04）。调整了年龄、性别、血压及空腹血糖等因素后，多元线性回归分析显示，BMI每增加1 kg/m²，HSA增加0.46 cm²，AP增加0.08 cm，TD增加0.07 cm（P均<0.001）。BMI与HSA、AP、TD均呈正相关。

能准确测量食管裂孔各项参数，提示BMI可能是I型HH的独立危险因素，BMI越高，食管裂孔的HSA、AP、TD越大。

To measure the dimensions of the esophageal hiatus in patients with type I hiatal hernia (HH) using multidetector computed tomography (MDCT) with multiplanar reconstruction (MPR) and to investigate their correlations with body mass index (BMI).

Clinical and imaging data from 106 patients with surgically confirmed type I HH at the Affiliated Hospital of Xuzhou Medical University between January 2022 and June 2025 were retrospectively collected and analyzed. The hiatal surface area (HSA), anteroposterior diameter (AP), and transverse diameter (TD) of the esophageal hiatus were measured using MDCT with MPR. According to BMI, the patients were divided into three groups: normal-weight, overweight, and obese groups. The correlations between BMI and HSA, AP, and TD were evaluated.

Comparisons among the three groups showed statistically significant differences in HSA (F=4.54, P=0.013, partial η²=0.08), AP (F=4.43, P=0.014, partial η²=0.08), and TD (F=9.85, P<0.001, partial η²=0.16), indicating medium to large effect sizes for BMI grouping on these esophageal hiatal measurements. No statistically significant differences were observed among the three groups in sex, age, height, systolic blood pressure, diastolic blood pressure, or fasting blood glucose (P>0.05, partial η²<0.04). After adjustment for age, sex, blood pressure, fasting blood glucose, and other factors, multiple linear regression analysis showed that each 1 kg/m² increase in BMI was associated with an increase of 0.46 cm² in HSA, 0.08 cm in AP, and 0.07 cm in TD (all P<0.001). BMI was positively correlated with HSA, AP, and TD.

MDCT with MPR can accurately measure various parameters of the esophageal hiatus. The findings suggest that BMI may be an independent risk factor for type I HH, with higher BMI associated with larger HSA, AP, and TD measurements of the esophageal hiatus.