NGHIÊN CỨU VAI TRÒ XQUANG CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN THỦNG TÁ TRÀNG

Abstract

Objective: The purpose of this study was to describe CT scan features caracteristics and determine the value of these features in diagnostic of duodenal perforation. Methods: Prospective cross-sectional research. All patients diagnosed with duodenal perforation who visited Trưng Vương hospital from 01/01/2021 to 31/10/2023 were examined for Multidedector comptued tomography (MDCT). MDCT imaging results were compared with surgical findings. Result: there were 39 patients meeting the selection critia, of which 26 patients with duodenal perforation were identified at surgery. Age ranged from 14-88 years, median age was 58 years. The most common age group is 40-59 years old (38.46%), group ≤ 40 years old and >80 years old together account for 15.4%. Clinical diagnosis is mainly monitoring duodenal perforation +/- peritonitis, accounting for 71.8%. Among CT features, free abdominal air is the most common sign (84.6%), with the highest sensitivity (88.5%) but the low specificity (23.1%). The least common sign is abscess adjacent to the duodenum (2.6%) with the lowest sensitivity (0%) but highest specificity (92.3%). The sensitivity and specificity of other features are respectively: focal air accumulation next to the duodenum (sensitivity 69.2% and specificity 76.9%), free abdominal air (sensitivity of 88, 5% and specificity of 23.1%), focal fluid next to the duodenum (sensitivity of 42.3% and specificity of 84.6%), abdominal free fluid (sensitivity of 76.9% and specificity of 7.7%), duodenal wall thickening (sensitivity of 26.9% and specificity of 69.2%). Combining the duodenal wall defect  and focal air accumulation next to the duodenum, the specificity and positive predictive value are approximately 100%. Conclusion: MDCT has an important role in diagnosing duodenal perforation.