| 张惟元,韩丹,江杰,李志明.CT预测急性肠系膜缺血继发性肠坏死[J].中国医学影像技术,2022,38(5):717~721 |
| CT预测急性肠系膜缺血继发性肠坏死 |
| CT for predicting acute mesenteric ischemia secondary intestinal necrosis |
| 投稿时间：2021-08-31 修订日期：2022-02-07 |
| DOI：10.13929/j.issn.1003-3289.2022.05.019 |
| 中文关键词: 肠系膜缺血 肠 坏死 体层摄影术,X线计算机 |
| 英文关键词:mesenteric ischemia intestines necrosis tomography, X-ray computed |
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| 中文摘要: |
| 目的 评估CT预测急性肠系膜缺血(AMI)继发性肠坏死的价值。方法 回顾性分析78例经手术病理证实AMI患者的腹部CT资料,根据是否发生继发性肠坏死将其分为肠坏死组(n=26)及无肠坏死组(n=52)。采用单因素分析和多因素logistic回归分析筛选CT预测AMI继发性肠坏死的独立因素,并建立联合模型,绘制受试者工作特征(ROC)曲线,评估其单一CT参数及联合模型预测AMI继发性肠坏死的效能,计算其曲线下面积(AUC)。结果 组间血管狭窄或闭塞、肠壁积气、肠系膜静脉积气、"缆绳征"及肠壁异常强化差异均有统计学意义(P均＜0.05)。CT所示肠系膜血管3级及以下分支狭窄或闭塞、肠壁积气和肠系膜静脉积气为预测AMI继发性肠坏死的独立预测因素(P均＜0.05);其预测AMI继发性肠坏死的AUC分别为0.66、0.73及0.72,联合模型的AUC为0.89。结论 CT对于预测AMI继发性肠坏死具有一定临床应用价值。 |
| 英文摘要: |
| Objective To explore CT value of predicting acute mesenteric ischemia (AMI) secondary intestinal necrosis.Methods Abdominal CT data of 78 AMI patients confirmed by surgical pathology were retrospectively analyzed. The patients were divided into intestinal necrosis group (n=26) and non-intestinal necrosis group (n=52). Univariate analysis and multivariate logistic regression analysis were used to screen the independent predictors of AMI secondary intestinal necrosis among CT manifestations to establish a combined model. Receiver operating characteristic (ROC) curves were drawn to evaluate the efficacy of single CT parameters and combined model for predicting AMI secondary intestinal necrosis, and the areas under the curve (AUC) were calculated.Results There were significant differences of stenotic or embolic vessels, intestinal wall gas, mesenteric vein gas, "cable sign" and abnormal intestinal wall enhancement between group (all P＜0.05). Stenosis or occlusion of grade 3 and below branches of mesenteric vessels, intestinal wall gas and mesenteric vein gas were all independent predictors for intestinal necrosis (all P＜0.05), with AUC of 0.66, 0.73 and 0.72, respectively, while the AUC of the combined model was 0.89.Conclusion CT had certain clinical application value for predicting intestinal necrosis secondary to AMI. |
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