The Value Of 256-slice Spiral CT Angiography In The Evaluation Of Preoperative Evaluation Of Abdominal External Hernia

Objective: 256-slice spiral CT angiography(Multi-slice spiral CT angiography,MSCTA)was used to classify the abdominal external hernia and observe the Corona Mortis.At the same time,the maximum diameter of the Hernia ring was measured preoperatively to explore the application value of MSCTA for preoperative evaluation of abdominal external hernia.Methods: The MSCTA data of patients with abdominal external hernia confirmed by operation in our Hospital from December 1,2016 to December 1,2017 were collected.A total of 285 cases(228 males and 57 females,ages 2-95 years,mean age 58.48±16.48 years)were included.using MSCTA classifying abdominal external hernia,and the Corona Mortis were observed.Taking the surgical results as the gold standard,the value of MSCTA for the classification of abdominal external hernia and the detection rate of MSCTA for the Corona Mortis were analyzed.any difference between each type hernia.Meanwhile,MSCT and soft ruler were used before and during surgery.The maximum diameter of the hernia ring was measured,and the two sets of data were compared and analyzed.Results:1.A total of 285 cases of external abdominal hernia were confirmed by surgery,including 169 cases of indirect hernia,33 cases of direct hernia,12 cases of femoral hernia,25 cases of composite hernia,and 46 cases of incisional hernia.The overall diagnostic accuracy of MSCTA in abdominal external hernia was 92.98%(265/285).The consistency test of KAPPA showed that the diagnostic results of MSCTA were highly consistent with the surgical results.The display rate of MSCTA in the inferior abdominal wall artery was up to 100%.Among the hernia types of external abdominal hernia,MSCTA has the lowest diagnostic accuracy rate of composite hernia,which is only 75.0%(18/24).In addition,MSCTA found 13 cases of occult hernia and 26 cases of inguinal hernia with spermatic lipoma,and confirmed by surgery.2.Among the 285 patients,166 of them were confirmed to be Corona Mortis by surgery and 165 cases of them were detected by MSCTA before surgery,which was one case less than the result of surgery,and the difference was not statistically significant.In abdominal external hernia,the incidence of Corona Mortis in indirect hernia was the highest(62.72%),while that in composite hernia was the lowest(50%).The average age of onset of patients with Corona Mortis was 69.29±14.96 years old,and the average age of onset of patients without Corona Mortis was 57.23.±15.82 years old,the former was significantly older than the latter(P<0.05),and the difference was statistically significant.3.The maximum diameter of the hernia ring was measured preoperatively and intraoperatively,and statistical analysis was performed on the measurement data of the two groups.The P value was > 0.05,and the difference was not statistically significant Conclusion: MSCTA are accurate and reliable in the classification of abdominal external hernia,the display of the Corona Mortis and the measurement of hernia ring diameter.which have important guiding significance in the formulation of surgical plans,the application of hernia mesh and the reduction of postoperative complications.