MSCT DIAGNOSTIC CRITERIA OF INTERNAL HERNIA WITH AN EMPHASIS ON COMMON PATHOLOGICAL BASIS, MAIN MSCT SIGNS, STAGING AND TYPING
PURPOSE: To derive useful multi-slice spiral computed tomography(MSCT) diagnostic procedure and criteria of internal hernia(IH) in china.MATERIALS AND METHODS: Retrospective review of medical records revealed30 patients with surgically proved IH, including 18 cases of traditional internal hernia(TIH) and 12 cases of belted adhesion intestinal hernia(BAIH).According to a widely accepted theory, IH is clinically divided into three stages: reversible hernia, incarcerated hernia and strangulated hernia, we concluded three common pathological basis of IH, every pathological basis was interpreted as three main MSCT signs, statistics and analysis were carried out on MSCT signs reflecting the pathological basis of IH.Then, we proposed three MSCT stages of IH,consistency test between pathological and MSCT staging results of IH was made using the Kappa value.RESULTS: ①On MSCT images, signs of mass effect due to ectopic accumulated intestine maily consist of sac-like loop herniated backward, closed loop herniated forward, and cluster-like loop herniated into pelvis; signs of closed loop maily consist of C-shaped loop sign with converged mesenteric vasculars, two kissed beak-like transition zone signs with smooth edges and SBO sign; signs of strangulation maily consist of target sign, whirl sign and bloody exudate.②there was a good agreement between pathological and MSCT staging results of IH.③As the representative of MSCT staging, encapsulated intestinal loops without dialation, mass effect due to abnormal anatomic site and vascular landmarks are considered to be important indicators in diagnosis of simple PDH.④As the most common acquired hernia in our investigation, BAIH has the same pathologic basis and similar imaging findings with TIH, manifesting as closed loop small bowel obstruction with belted adhesion.CONCLUSION: It is important for both radiologists and clinicians to be familiar with common pathological basis,main imaging signs, and MSCT staging of IH for MSCT diagnostic procedure and criteria.BAIH is an important supplement to typing of TIH.
internal hernia multi-slice spiral computed tomography belted adhesion intestinal hernia staging typing
JIANG Chuanwu ZHAO Bin LI Wenhua GAO Rui CHEN Fei JIANG Duyin Zhao Demin
Department of Radiology, Qingdao Hiser hospital, Qingdao, Shandong, China Shandong Medical Imaging Research Institute, Jinan, Shandong, China Department of emergency,The Second Hospital of Shandong University, Jinan, Shandong, China Department of emergency,Qingdao Hiser hospital, Qingdao, Shandong, China
国内会议
山东预防医学会第三届中毒与临床急病防治分会学术会议暨山东中西医结合学会第二届急救医学分会第四次学术会议
济南
英文
268-273
2013-09-13（万方平台首次上网日期，不代表论文的发表时间）