Abstract
To retrospectively analyze the use of artificial pneumoperitoneum in CT scans, to explore its operation methods and technical points, and to lay the foundation for the widespread application of artificial pneumoperitoneum in CT. A total of 331 patients who underwent artificial pneumoperitoneum with CT angiography from January 1, 2013, to November 1, 2019, were recruited. All patients underwent standardized artificial pneumoperitoneum in the horizontal, left and right lateral, and prone positions during CT thin-layer scans of the abdomen and 3D reconstruction. Taking the surgical results as the gold standard, and using kappa test to verify the consistency of surgical results and imaging results. In all 331 patients, 43 patients had a normal peritoneal space, and 288 patients had an abnormal peritoneal space. And only 22 patients developed complications of subcutaneous emphysema, accounting for 6.6% of all 331 patients. In terms of the postoperative results, 28 were normal, and 303 were abnormal. The sensitivity, specificity and accuracy of CT diagnosis of abdominal adhesions using artificial pneumoperitoneum were 100%, 95.04%, and 95.46%, respectively. According to the Kappa consistency test, the imaging diagnosis from the CT scan with artificial pneumoperitoneum had a high consistency with the surgical results (kappa = 0.796, P < 0.05). The technique of artificial pneumoperitoneum CT is safe, reliable, highly practical, and proficient for obtaining good imaging results. It provides a good imaging basis for the diagnosis of intra-abdominal diseases, especially intra-abdominal adhesions.
Highlights
To retrospectively analyze the use of artificial pneumoperitoneum in CT scans, to explore its operation methods and technical points, and to lay the foundation for the widespread application of artificial pneumoperitoneum in CT
The axial view of the normal artificial pneumoperitoneal image showed a bulging abdomen; the visceral peritoneum was separated from the peritoneum of the abdominal wall, the peritoneal cavity was full of gas, the pneumoperitoneal space was clearly displayed, the abdominal wall was thin and uniform, and the inner surface was smooth
The abdominal internal organs were in close contact with the anterior abdominal wall under the action of gravity, and air filled the space between the posterior abdominal wall and the visceral peritoneum
Summary
To retrospectively analyze the use of artificial pneumoperitoneum in CT scans, to explore its operation methods and technical points, and to lay the foundation for the widespread application of artificial pneumoperitoneum in CT. The technique of artificial pneumoperitoneum CT is safe, reliable, highly practical, and proficient for obtaining good imaging results It provides a good imaging basis for the diagnosis of intra-abdominal diseases, especially intra-abdominal adhesions. Since adhesion pathology does not involve volume changes and the physical and chemical properties of the surrounding tissues are the same, the imaging examination of intra-abdominal adhesions is very difficult, and it can only rely on indirect imaging signs such as local intestinal wall thickening, a relatively fixed intestinal position, and panniculitis[1,2]; on the other hand, exploratory laparotomy and laparoscopy can be used to confirm the diagnosis. The use of CT scans with artificial pneumoperitoneum can obtain the tomographic anatomy of abdominal internal organs and the peritoneal space with imaging, providing a more intuitive basis for the diagnosis and treatment of intra-abdominal diseases. Treatment technology, in this study, artificial pneumoperitoneum CT examinations were performed in patients with high clinical suspicion of intra-abdominal adhesions. We will summarize this method of artificial pneumoperitoneum CT and related technical points
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