ObjectiveTo explore the feasibility and safety of the artificial pneumoperitoneum and gastrointestinal contrast CT imaging, and imaging diagnostic value on abdominal wall adhesion to intestine after operation. MethodsThirtynine patients with adhesive intestinal obstruction after operation relieved by conservative therapy were included from January 2008 to November 2009. After the artificial pneumoperitoneum established by injection of gas into abdominal cavity and gastrointestinal comparison by oral administration low concentration of meglucamine diatrizoate, CT scan imaging was performed and the radiographic results were compared with surgical findings. ResultsFour patients refused surgery and discharged, so enterolysis was performed in the remaining patients. The surgical findings were consistent with radiographic results. It was showed by laparoscopic operation that intestinal obstruction caused by the fibrous adhesions and the intestine did not adhere to the abdominal wall in eight patients with fibrous adhesion diagnosed by CT. Of eighteen patients with the abdominal wall septally adhered to the intestinal, the surgical findings showed the intestine and the abdominal wall formed “M”type adhesions and omentum adhesions in sixteen patients underwent open operation, and clear fat space was showed in eight patients and close adhesion was found in another eight patients between the intestine and abdominal wall. Of thirteen patients with the abdominal wall tentiformly adhered to the intestinal, the surgical findings showed the intestine and the abdominal wall formed continuous and tentiform adhesions and omentum adhesions to the intestine in eleven patients. After the followup of 6-18 months (mean 9 months), incomplete intestinal obstruction occurred in one patient and was relieved by conservative treatment. One patient with discontinuous discomfort in abdomen after operation did not receive any treatment. The other patients were cured. ConclusionThe artificial pneumoperitoneum and gastrointestinal contrast CT imaging can accurately show the location, area, and structure composition of the postoperative abdominal wall adhesion to intestine, which is safety, simple, and bly repeatable, and a better imaging method for the diagnosing of abdominal wall adhesion to intestine after operation.
ObjectiveTo summarize the application of dual-energy CT scanning technology in the liver. MethodsTo search the relevant literatures at home and abroad, then the application of dual-energy CT scanning technology in focal liver lesions, diffuse liver lesions were analyzed and summarized. ResultsDual-energy CT scanning technology can improve detection rate of the focal liver lesions, liver cancer recurrence lesions after local treatment and help to differentiate focal liver lesions, to stage the malignant lesions, and it also can be more accurate quantification of liver iron, fat content, indirect measurement of hepatic blood flow dynamics change situation. ConclusionDual-energy CT scanning technology can improve the diagnostic value of CT scanning technology in liver disease.
ObjectiveTo explore the consistency and clinical application value of Balthazar CT classification and extra-pancreatic inflammation on computed tomography (EPIC) score in the diagnosis of acute pancreatitis (AP). MethodsA total of 100 continuous patients with AP were included in the Hainan Academy of Traditional Chinese Medicine from April 2019 to April 2021, who were divided into mild (n=41), moderate (n=37), and severe (n=22) AP, and all of them underwent the abdominal CT examination. The Balthazar CT classification score, EPIC score, and acute physiology and chronic health evaluation Ⅱ (APACHE-Ⅱ) score were compared and the correlations were analyzed among 3 groups. The consistency of Balthazar CT classification score or EPIC score and clinical classification was analyzed. ResultsThere were statistical differences in the Balthazar CT classification score [(1.58±0.29) points vs. (2.43±0.36) points vs. (3.20±0.51) points, F=13.261, P<0.001], EPIC score [(2.56±0.30) points vs. (4.29±0.77) points vs. (5.68±0.82) points, F=14.672, P<0.001], and APACHE-Ⅱ score [(21.40±6.22) points vs. (29.13±7.31) points vs. (39.37±8.18) points, F=13.906, P<0.001] among mild, moderate, and severe 3 groups. The points of the three indexes increased statistically with the severity of AP (P<0.05). The Balthazar CT classification score was positively correlated with APACHE-Ⅱ score and EPIC score (r=0.537, P<0.001; r=0.609, P<0.001), and EPIC score was positively correlated with APACHE-Ⅱ score (r=0.582, P<0.001). The Kappa values of Balthazar CT classification score or EPIC score and clinical classification for assessing the severity of AP were 0.731 and 0.704, respectively. ConclusionsFrom the preliminary results of this study, Balthazar CT classification score and EPIC score increase obviously with the aggravation of AP and which has a higher consistency, and are positively correlated with APACHE-Ⅱ score. It is suggested that abdominal CT has a good clinical application value in the assessment of severity of AP.