Reappraisal of the diagnostic value of plain radiography, computed tomography and ultrasonography for gastrointestinal perforation(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2019年第3期
- Page:
- 316-321
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Reappraisal of the diagnostic value of plain radiography, computed tomography and ultrasonography for gastrointestinal perforation
- Author(s):
- ZHU Jiaying; LI Long
- Department of Radiology, Guangdong Armed Police Corps Hospital, Guangzhou Medical University, Guangzhou 510507, China
- Keywords:
- ; Keywords: gastrointestinal perforation; plain radiography; computed tomography; ultrasonography
- PACS:
- R656
- DOI:
- DOI:10.3969/j.issn.1005-202X.2019.03.014
- Abstract:
- Abstract: Objective To revaluate the diagnostic value of plain radiography, computed tomography (CT) and ultrasonography (US) for gastrointestinal perforation. Methods The direct or indirect signs of gastrointestinal perforation in plain radiography, CT and US were analyzed according to literatures. The imaging data of 284 patients with gastrointestinal perforation confirmed by surgery were reviewed retrospectively. The positive rates of 3 kinds of examinations, namely plain radiography, CT and US, were compared. The relationships between the positive rates of imaging signs and the sites or sizes of gastrointestinal perforation were analyzed. Results The positive rates of plain radiography, CT and US in the diagnosis of gastrointestinal perforation were 75.9%, 92.7% and 42.1%, respectively. Other pneumoperitoneum signs (32.8%) were observed in orthostatic radiograph besides subphrenic free air (73.5%). Moreover, various pneumoperitoneum signs (68.7%) were observed in supine abdominal radiograph. Focal wall disruption (22.8%), free intraperitoneal air (86.2%) and gas bubbles adjacent to the wall (68.3%) were direct signs of gastrointestinal perforation that can be detected by CT examination. The detection rate of free peritoneal air which was the direct sign of gastrointestinal perforation in US was only 1.8%. For plain radiography, there was statistical significance between the positive rates of imaging signs and the sites or sizes of gastrointestinal perforation. However, for CT and US, no statistical significance was found between the positive rates of imaging signs and sites or sizes of gastrointestinal perforation. The positive rate of CT in the diagnosis of gastrointestinal perforation was the highest, followed by plain radiography and then US (all P<0.05). Conclusion For patients with suspected gastrointestinal perforation, plain radiography should be considered as the first choice for imaging examination. Meanwhile, it is necessary to improve the understanding of various pneumoperitoneum signs. If no signs were showed on the plain radiography, US is a preferable choice, and CT should be selected when the image-guided positioning is required in clinic.
Last Update: 2019-03-26