Exploring the clinical value and accuracy of multislice spiral CT in the radiological diagnosis of intestinal obstruction
探讨肠梗阻放射诊断中多层螺旋CT的临床价值和准确性

摘要

目的 探讨多层螺旋CT在肠梗阻放射诊断中的临床价值及准确性，为临床早期明确梗阻部位、病因及病情严重程度提供可靠依据。方法 选取2024年3月-2025年3月本院收治的60例经手术或临床综合确诊的肠梗阻患者为研究对象，所有患者均于入院后24h内完成腹部多层螺旋CT平扫及增强扫描，由2名高年资影像科医师采用双盲法阅片，分析梗阻部位、梗阻原因、肠壁血运情况等影像学表现；同时以手术或临床综合确诊结果为金标准，对比多层螺旋CT与传统腹部X线平片的诊断符合率。结果 60例肠梗阻患者中，手术证实梗阻部位位于小肠38例、结肠22例；梗阻病因包括粘连性梗阻25例、肿瘤性梗阻16例、粪石性梗阻9例、肠扭转7例、疝嵌顿3例。多层螺旋CT诊断梗阻部位的符合率为98.33%（59/60），诊断梗阻病因的符合率为95.00%（57/60）；传统腹部X线平片诊断梗阻部位符合率为76.67%（46/60），病因符合率为68.33%（41/60），两者比较差异均有统计学意义（P<0.05）。结论 多层螺旋CT在肠梗阻诊断中具有较高的准确性，可清晰显示梗阻部位、病因及肠壁血运状态，为临床制定治疗方案提供关键影像学信息，具有重要的临床应用价值。

Abstract

Objective To explore the clinical value and accuracy of multislice spiral CT in the radiological diagnosis of intestinal obstruction, providing a reliable basis for early clinical determination of the obstruction location, cause, and severity of the condition.
Methods A total of 60 patients with intestinal obstruction admitted to our hospital from March 2024 to March 2025, confirmed by surgery or comprehensive clinical diagnosis, were selected as the study subjects. All patients underwent abdominal multislice spiral CT plain and enhanced scans within 24 hours of admission. Imaging findings such as the location of obstruction, cause of obstruction, and intestinal wall perfusion were analyzed by two senior radiologists using a double-blind method. The concordance rates of multislice spiral CT and conventional abdominal X-ray in diagnosing obstruction were compared, using surgical or comprehensive clinical results as the gold standard.
Results Among the 60 patients with intestinal obstruction, surgery confirmed that 38 cases had obstructions in the small intestine and 22 in the colon. Causes of obstruction included adhesive obstruction in 25 cases, tumor-related obstruction in 16 cases, fecal impaction in 9 cases, intestinal volvulus in 7 cases, and incarcerated hernia in 3 cases. The concordance rate of multislice spiral CT in diagnosing the obstruction location was 98.33% (59/60), and in diagnosing the cause of obstruction was 95.00% (57/60) respectively. For conventional abdominal X-rays, the concordance rate for obstruction location was 76.67% (46/60) and for cause of obstruction was 68.33% (41/60). The differences between the two methods were statistically significant (P<0.05).
Conclusion   Multislice spiral CT has high accuracy in diagnosing intestinal obstruction. It can clearly show the obstruction location, cause, and intestinal wall perfusion status, providing critical imaging information for clinical treatment planning, and has important clinical application value.