Diagnosis of Inguinal Region Hernia in Multi-detector Row CT_West China Medical Journal

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Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

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Keywords：

疝; 腹股沟区; 诊断; 断层摄影术/X线计算机; 重建

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【摘要】目的 评价多排螺旋CT（MDCT）在腹股沟区疝诊断中的价值。方法回顾性分析2009年6-12月96例经临床证实为腹股沟区疝患者的CT图像资料。通过多平面重建技术获得冠状位及矢状位图像，评价不同平面图像在腹股沟区疝诊断及分类中的应用价值。结果 63例斜疝患者（66疝）疝囊于腹壁下动脉外侧经腹股沟深环进入腹股沟管，疝囊位于精索或圆韧带前侧（43/66，65.2%）或前内侧（15/66，22.7%）；30例直疝患者（37疝）疝囊位于腹壁下动脉内侧，位于精索内侧（27/37，73.0%）；斜疝及直疝疝囊均走行于腹股沟韧带前上方；3例股疝患者（3疝）疝囊位于腹股沟韧带后下方，冠状位“影像学股三角”内。结论 MDCT对腹股沟区疝的诊断与鉴别诊断具有重要价值，可为手术前评估及手术中操作提供重要参考信息。
【Abstract】 Objective To assess the value of multi-detector row CT (MDCT) in diagnosis of the inguinal region hernia. Methods The CT images of 96 patients with inguinal region hernia from June to December 2009 were retrospectively analyzed. The diagnosis and application of coronal and sagittal views in inguinal region hernia were assessed by multi-planer reconstruction. Results Hernia sac in 63 indirect hernia patients (66 hernias) originated lateral to the inferior epigastric artery enter the inguinal canal through the deep ring, anterior (43/63,68.3%) or anteromedial (15/63,23.8%) to the spermatic cord or round ligament;sac in 30 direct hernia patients (37 hernias) originated medial to the inferior epigastric artery, medial to the spermatic cord;both indirect and direct hernia sac located anterosuperior to the inguinal ligament;sac in three femoral hernia patients (three hernias) located posterior to the inguinal ligament and inside the “radiological femoral triangle” of coronal views. Conclusion MDCT plays on important role in diagnosing the inguinal region hernia, and provides critical information for preoperative and intraoperative.

Citation： ZHAO Shuang,LIU Rongbo,ZHOU Ying,ZHOU Haiying. Diagnosis of Inguinal Region Hernia in Multi-detector Row CT. West China Medical Journal, 2010, 25(9): 1670-1672. doi: Copy

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14.	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.
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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. van den Berg JC, de Valois JC, Go PM, et al. Radiological anatomy of the groin region[J]. Eur Radiol, 2000, 10(4): 661-670.
3. Cherian PT, Parnell AP. Radiologic anatomy of the inguinofemoral region: insights from MDCT [J]. AJR Am J Roentgenol, 2007, 189(4): 177-183.
4. Cherian PT, Parnell AP. The diagnosis and classification of inguinal and femoral hernia on multisection spiral CT [J]. Clini Radiol, 2008, 63(2): 184-192.
5. Ianora AA, Midiri M, Vinci R, et al. Abdominal wall hernias: imaging with spiral CT[J]. Eur Radiol, 2000, 10(6): 914-919.
6. Delabrousse E, Michalakis D, Sarliève P, et al. Value of the pubic tubercle as a CT reference point in groin hernias[J]. J Radiol, 2005, 86(6): 651-654.
7. Simons MP, Aufenacker T, Bay-Nielsen M, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients [J]. Hernia, 2009, 13(4): 343-403.
8. Felix EL, Harbertson N, Vartanian S. Laparoscopic hernioplasty: significant complications[J]. Surg Endosc, 1999, 13(4): 328-331.
9. Knook MT, Weidema WF, Stassen LP, et al. Endoscopic totally extraperitoneal repair of bilateral inguinal hernias[J]. Br J Surg, 1999, 86(10): 1312-1316.
10. Knook MT, Weidema WF, Stassen LP, et al. Laparoscopic repair of recurrent inguinal hernias after endoscopic herniorrhaphy[J]. Surg Endosc, 1999, 13(11): 1145-1147.
11. 秦良誉, 夏春波, 周思, 等. 腹壁下动脉的应用解剖与临床意义 [J]. 华夏医学, 2007, 20 (5): 898-899.
12. Saber AA, Meslemani AM, Davis R, et al. Safety zones for anterior abdominal wall entry during laparoscopy: a CT scan mapping of epigastric vessels [J]. Ann Surg, 2004, 239 (2): 182-185.
13. 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.
14. 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.
15. Suzuki S, Furui S, Okinaga K, et al. Differentiation of femoral versus inguinal hernia: CT findings [J]. AJR Am J Roentgenol, 2007, 189(2): 78-83.

West China Medical Journal

Diagnosis of Inguinal Region Hernia in Multi-detector Row CT

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