上消化道异物的多层螺旋CT诊断价值
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摘要
目的:探讨多层螺旋CT(MSCT)在上消化道异物及其并发症中的诊断价值。方法:回顾性分析2012年8月至2017年8月佛山市顺德区容桂街道新容奇医院收治的25例经过内镜及手术证实的诊断为上消化道异物患者的临床资料及CT影像,对其进行分析。结果:喉咽部异物10例,食管异物13例,胃内异物1例,十二指肠异物1例,其中合并周围软组织肿胀8例,颈部蜂窝织炎2例,纵隔气肿并感染1例,食管–胸膜瘘1例,食道癌1例,十二指肠穿孔1例;异物成分中鱼刺16例,禽类骨块4例,肉团1例,枣核1例,玉佩1例,牙签1例,溃疡钡剂滞留1例。8例先行X线食道吞钡棉絮检查,3例结果呈阳性,敏感性为37.5%(3/8);24例经MSCT准确检出,准确率为96.0%(24/25),1例误诊。结论:MSCT检出异物准确性高,能清楚显示异物的位置、形态及有无并发症,是平片及吞钡棉检查后重要的补充检查手段。
Objective To evaluate the diagnostic value of MSCT in the upper gastrointestinal tract foreign body and its complications. Methods Retrospective analysis of 25 cases of endoscopic and surgically confi rmed clinical data and CT images of patients with upper digestive tract foreign body admitted to Xinrongqi Hospital, Ronggui Street, Shunde District, Foshan City from August 2012 to August 2017. Results Foreign bodies located in the throat in 10 cases, oesophagus in 13 cases, stomach in 1 cases, duodenum in 1 case. Among the 8 cases with peripheral soft tissue swelling, 2 cases with abscess, 1 case with esophagealpleura fi stula, 1 case with esophagus cancer, 1 case with duodenum perforation. 16 cases were fi shbone, 4 cases were bird and animal bone, 1 case were meatball, 1 case were jujube seed, 1 case were jade, 1 case were bamboo prod, 1 case were barium retention in ulcer. 8 cases of X-ray barium meal examination, the results were positive in 3 cases, the sensitivity is 37.5%(3/8); in 24 cases were detected, the accuracy rate was 96%(24/25), 1 cases of misdiagnosis. Conclusion High sensitivity of MSCT in detecting foreign body, it can clearly show the location of the foreign body、form、complications, it is an important supplementary means of inspection after the examination of X-ray and barium swallowing.
Objective To evaluate the diagnostic value of MSCT in the upper gastrointestinal tract foreign body and its complications. Methods Retrospective analysis of 25 cases of endoscopic and surgically confi rmed clinical data and CT images of patients with upper digestive tract foreign body admitted to Xinrongqi Hospital, Ronggui Street, Shunde District, Foshan City from August 2012 to August 2017. Results Foreign bodies located in the throat in 10 cases, oesophagus in 13 cases, stomach in 1 cases, duodenum in 1 case. Among the 8 cases with peripheral soft tissue swelling, 2 cases with abscess, 1 case with esophagealpleura fi stula, 1 case with esophagus cancer, 1 case with duodenum perforation. 16 cases were fi shbone, 4 cases were bird and animal bone, 1 case were meatball, 1 case were jujube seed, 1 case were jade, 1 case were bamboo prod, 1 case were barium retention in ulcer. 8 cases of X-ray barium meal examination, the results were positive in 3 cases, the sensitivity is 37.5%(3/8); in 24 cases were detected, the accuracy rate was 96%(24/25), 1 cases of misdiagnosis. Conclusion High sensitivity of MSCT in detecting foreign body, it can clearly show the location of the foreign body、form、complications, it is an important supplementary means of inspection after the examination of X-ray and barium swallowing.
引文
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[2]田勇泉.耳鼻咽喉头颈外科学[M].8版.北京:人民卫生出版社,2013:219-220.
[3]董刚志,黄荣忠,卢竞.16层螺旋CT三维重建成像在食源性食管异物诊断中的价值[J].临床影像技术,2011,26(1):147-148.
[4]梁碧玲.临床急诊放射诊断学[M].广州:广东科技出版社,2003.
[5]徐婷,袁渊,吴四海,等.钡棉检查在食道异物诊治中引起的并发症[J].中国耳鼻咽喉头颈外科,2016,23(11);665-666.
[6]张龙,聂玉强,李瑜元.内镜治疗上消化道异物70例分析[J].中国内镜杂志2007,13(6):648-653.