Objective To assess the significance of multi-detector row CT in differential diagnosis of the inguinal hernia and femoral hernia.
Methods CT images which were reconstructed by multi-planer reconstruction (MPR) of 260 patients with inguinal hernia and femoral hernia who treated in our hospital form Oct. 1, 2012 to Oct. 31, 2013 were analyzed retrospectively, for exploring the relationship between sac and anatomic structure in the groin area.
Results There were 146 patients with indirect hernia (75 in right, 60 in left, and 11 in bilateralism), 82 patients with direct hernia(39 in right, 34 in left, and 9 in bilateralism), and 32 patients with femoral hernia (17 in right and 15 in left). The 157sacs of patients with indirect hernia originated lateral to the inferior epigastric artery, entered the inguinal canal and through the deep ring, which mainly located anterior (103/157, 65.6%) or anteromedial (36/157, 22.9%) to the spermatic cord or round ligament. The 91 sacs of patients with direct hernia originated medial to the inferior epigastric artery, and mainly located medial to the spermatic cord (70/91, 76.9%). Sacs of both indirect hernia and direct hernia located anterosuperior to the inguinal ligament. The 32 sacs of patients with femoral hernia located posterior to the inguinal ligament and inside the “radiological femoral triangle” of coronal views.
Conclusions The MPR images available from multi-detector row CT permit the accurate diagnosis of groin hernias. By using simple anatomical criteria, direct hernia, indirect hernia, and femoral hernia can be reliably distinguished.
Citation:
ZHAO Shuang,HUANG Zixing,LIU Rongbo.. Differential Diagnosis of Inguinal Hernia and Femoral Hernia by Multi-Detector Row CT. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(12): 1424-1427. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 1. 李富年, 周荣祥, 李扬, 等. 腹壁与疝外科学[M]. 北京:人民卫生出版社, 2004:211-240.
- 2. Delabrousse E, Denue PO, Aubry S, et al. The pubic tubercle:a CT landmark in groin hernia[J]. Abdom Imaging, 2007, 32(6):803-806.
- 3. 曾庆娟, 许崇永, 吴爱琴, 等. 腹股沟疝的CT诊断[J]. 中国临床医学影像杂志, 2008, 19(4):296-298.
- 4. 潘华山, 匡楚龙, 蔡云国, 等. 腹股沟疝和股疝的多层螺旋CT表现[J]. 中国CT和MRI杂志, 2012, 10(6):88-90.
- 5. 邓义. 股疝的MSCT诊断[J]. 当代医学, 2011, 17(8):79-81.
- 6. Ianora AA, Midiri M, Vinci R, et al. Abdominal wall hernias:imaging with spiral CT[J]. Eur Radiol, 2000, 10(6):914-919.
- 7. van den Berg JC, de Valois JC, Go PM, et al. Radiological ana-tomy of the groin region[J]. Eur Radiol, 2000, 10(4):661-670.
- 8. 赵爽, 黄子星, 刘荣波, 等. 成人腹股沟区CT影像解剖[J]. 中国普外基础与临床杂志, 2010, 17(6):622-626.
- 9. 邵志红, 王培军, 高晓龙, 等. 腹股沟区多层螺旋CT解剖及其临床意义[J]. 临床放射学杂志, 2010, 29(9):1211-1215.
- 10. 沈超, 张联合, 陈文辉, 等. 多层螺旋CT在腹股沟区解剖中的应用[J]. 放射学实践, 2011, 26(10):1079-1080.
- 11. Cherian PT, Parnell AP. Radiologic anatomy of the inguinofe-moral region:insights from MDCT[J]. AJR Am J Roentgenol, 2007, 189(4):W177-W183.
- 12. Cherian PT, Parnell AP. The diagnosis and classification of ing-uinal and femoral hernia on multisection spiral CT[J]. ClinRadiol, 2008, 63(2):184-192.
- 13. 赵爽, 刘荣波, 周莹, 等. 成人腹股沟区疝的CT诊断[J]. 华西医学, 2010, 25(9):1670-1672.
- 14. 皇旭辉, 卢跃忠, 葛宇曦. 多层螺旋CT扫描及重建技术在腹股沟疝分类中的应用[J]. 医学影像学杂志, 2013, 23(2):226-229.
- 15. 羊惠君, 王怀经, 王建本, 等. 实地解剖学[M]. 北京:人民卫生出版社, 2002:208-209.
- 16. Burkhardt JH, Arshanskiy Y, Munson JL, et al. Diagnosis of inguinal region hernias with axial CT:the lateral crescent sign andother key findings[J]. Radiographics, 2011, 31(2):E1-E12.
- 17. Kitami M, Takase K, Tsuboi M, et al. Differentiation of femoral and inguinal hernias on the basis of anteroposterior relationship to the inguinal ligament on multidimensional computed tomography[J]. J Comput Assist Tomogr, 2009, 33(5):678-681.
- 18. Suzuki S, Furui S, Okinaga K, et al. Differentiation of femoral versus inguinal hernia:CT findings[J]. AJR Am J Roentgenol, 2007, 189(2):W78-W83.