Objective To discuss the value of multiple window parameters of MSCT in gastrointestinal perforation . Methods We analysed retrospectively imaging findings of 42 cases of gastrointestinal perforation confirmed by operation and discussed the value of dissociative gas on CT image of lung window ,abdominal window and fat window .Results In all 42 cases , there are differences in three kinds of windows observing dissociative gas .Statistical analysis shows as fouows :surface of live (χ²= 7 .536 ,P < 0 .05) lesser omentum bursa (χ² = 6 .991 ,P < 0 .05) porta hepatis and hepatic fissure (χ² = 8 .663 ,P < 0 .05) gastrosplenic space (χ²= 0 .577 ,P > 0 .05) pararenal space (χ² = 0 .097 ,P > 0 .05) a‐round the colon (χ² = 0 .686 ,P > 0 .05) around the mesentery and small intestine (χ²= 27 .118 ,P > 0 .05) surface of o‐mentum majus (χ²= 0 .445 ,P > 0 .05) ileocecus (χ²= 5 .072 ,P > 0 .05) around the rectum and sigmoid colon (χ² =10.286 ,P < 0 .05) .Conclusion Observing the dissociative gas of epigastrium should select lung window and abdominal window .Observing the dissociative gas of midabdomen should select fat window .Observing the dissociative gas of pelvic cavity should select abdominal window .%目的：探讨C T扫描后多种窗宽、窗位调整技术在胃肠穿孔诊断中的价值。方法对42例临床确诊的胃肠穿孔病例的 CT 表现进行回顾性分析，观察肺窗、腹窗、脂肪窗在发现不同部位气腹征的差异。结果本组研究中合理运用三种窗宽、窗位技术可以提高气腹征的检出率，经礸2检验分析显示不同部位气腹征的统计数据如下：肝脏表面周围（礸2＝7．536，P ＜0．05），胃小网膜囊（礸2＝6．991，P ＜0．05），肝门肝裂部（礸2＝8．663，P ＜0．05），胃脾间隙（礸2＝0．577，P＞0．05），肾周（礸2＝0．097，P ＞0．05），升降结肠周围（礸2＝0．686，P ＞0．05），肠系膜及小肠周围（礸2＝27．118，P ＜0.05），大网膜前后（礸2＝0．445，P ＞0．05），回盲部（礸2＝5．072，P ＞0．05），直肠、乙状结肠周围（礸2＝10．286，P ＜0．05）。结论肺窗对肝脏表面周围游离气体检出率最高，腹窗对胃小网膜囊及肝门、肝裂积气显示较好；对于肠系膜及小肠周围积气首选脂肪窗；直肠、乙状结肠周围的积气以腹窗显示率最高；因此上腹部应该选择肺窗和腹窗来观察气腹征，中腹部首选脂肪窗观察气腹征，下腹、盆腔的游离气体使用标准腹窗更利于发现气腹征。
展开▼
