To analyze the classification and application value of MSCT in inguinal hernia.

A total of 102 patients with inguinal hernia admitted to the Department of Surgery at Ningguo People's Hospital from May 2018 to March 2021 were selected as the research objects. The types of oblique hernia, direct hernia and femoral hernia examined by MSCT were analyzed, the diagnosis and surgical results of MSCT were compared, and the diagnostic efficacy of MSCT was analyzed. The diagnostic coincidence rate of MSCT in transverse, coronal and sagittal positions was compared to analyzing the imaging signs of inguinal hernia by MSCT.

Among the 102 patients, 70 were simple oblique hernia, 20 were simple direct hernia, 5 were simple femoral hernia, 2 were left recurrent direct inguinal hernia, and 5 were right incarcerated inguinal and femoral hernia. The CT diagnosis of oblique hernia was 64.71% (66/102), direct hernia 16.67% (17/102), and femoral hernia 6.86% (7/102). The specificity, sensitivity, and positive predictive value of MSCT in the diagnosis of oblique hernia were 8.33%, 91.67% and 91.67%, respectively. The specificity, sensitivity, and positive predictive value of direct hernia were 15.00%, 85.00% and 85.00%, respectively. The specificity, sensitivity, and positive predictive value of femoral hernia were 30.00%, 70.00%, and 70.00%, respectively. The diagnostic coincidence rate of coronal slice CT was 99.02%, slightly higher than that of sagittal slice CT 98.04% (P>0.05). The diagnostic coincidence rate of coronal position was 99.02%, significantly higher than that of transverse position 75.49% (P<0.05). The diagnostic coincidence rate of the sagittal position was 98.04%, which was significantly higher than the 75.49% of the transverse position (P<0.05). There were 105 hernia sacs in 102 patients, 72 hernia sacs in oblique hernia patients, 23 hernia sacs in direct hernia patients, and 10 hernia sacs in femoral hernia patients. The inguinal canal ring was enlarged in 93.06% (67/72) of the oblique hernia sacs, and the inguinal canal ring was normal in direct hernia and femoral hernia sacs. There was no femoral trigonal packing in the hernia sacs of oblique and direct hernia, and femoral trigonal packing in the hernia sacs of femoral hernia; the lateral crescent sign was not found in oblique hernia and femoral hernia sacs. 82.61% (19/23) of straight hernia sacs had a lateral crescent sign. The oblique and direct hernia sacs are located in front of the inguinal ligament, while the femoral hernia sacs are located behind the inguinal ligament. 90.28% (65/72) of the oblique hernia sac wall was lateral to the inferior epigastric artery, the direct hernia sac wall was medial to the inferior epigastric artery, and the femoral hernia sac wall was posterior and inferior to the inferior epigastric artery.

Multi-slice spiral CT is helpful in the diagnosis of inguinal hernia, and when combined with the clinical understanding of the anatomical structure of the inguinal region, it is of great value in the classification of direct inguinal hernia, oblique hernia, and femoral hernia.