Application of multi-slice spiral CT in the preoperative diagnosis and classification of inguinal hernia

SONG Qing-jie; ZHU Hong-yu; SONG Hui; HU Qing-chao; ZHU Zhong-hui

doi:10.11659/jjssx.04E024047

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Application of multi-slice spiral CT in the preoperative diagnosis and classification of inguinal hernia

Clinical Research | 更新时间：2025-05-26

- Application of multi-slice spiral CT in the preoperative diagnosis and classification of inguinal hernia
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 5, Pages: 401-404(2025)
- 作者机构：
  
  启东市人民医院/启东肝癌防治研究所/南通大学附属启东医院普外二科，江苏启东 226200
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.04E024047
  CLC： R445.3
- Received：11 April 2024，
  
  Published：25 May 2025
- 稿件说明：
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宋庆杰,朱泓宇,宋辉等.多层螺旋CT在腹股沟疝术前诊断及分型中的应用[J].局解手术学杂志,2025,34(05):401-404.

SONG Qing-jie,ZHU Hong-yu,SONG Hui,et al.Application of multi-slice spiral CT in the preoperative diagnosis and classification of inguinal hernia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):401-404.
宋庆杰,朱泓宇,宋辉等.多层螺旋CT在腹股沟疝术前诊断及分型中的应用[J].局解手术学杂志,2025,34(05):401-404. DOI： 10.11659/jjssx.04E024047.

SONG Qing-jie,ZHU Hong-yu,SONG Hui,et al.Application of multi-slice spiral CT in the preoperative diagnosis and classification of inguinal hernia[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(05):401-404. DOI： 10.11659/jjssx.04E024047.

摘要

目的

分析多层螺旋CT（MSCT）在腹股沟疝术前诊断及分型中的应用价值。

方法

收集本院收治的130例腹股沟疝患者的临床资料，所有患者均行腹股沟疝修补术。采用MSCT对患者腹股沟疝进行检查，以术中诊断结果为金标准，探究MSCT对不同分型腹股沟疝的诊断效能；分析不同分型腹股沟疝患者疝囊内容物的检出情况，并分析MSCT不同扫描方向评估腹股沟疝疝囊颈与腹壁下动脉关系的准确率。

结果

经术中诊断证实，130例腹股沟疝患者中斜疝92例、直疝26例、股疝12例；共139个疝囊，其中单侧121个，双侧9个；斜疝中单侧87例、双侧5例，直疝中单侧23例、双侧3例，股疝中单侧11例、双侧1例。MSCT扫描结果显示，斜疝、直疝、股疝的患者分别为92例、26例、12例；MSCT诊断斜疝、直疝及股疝的灵敏度分别为95.65%、84.62%、100%，特异度分别为89.47%、96.15%、100%。斜疝疝囊内容物主要为小肠、肠系膜，直疝、股疝疝囊内容物主要为小肠、脂肪。直疝疝囊内容物中脂肪、膀胱占比高于斜疝、股疝（

0.05）；斜疝疝囊内容物中肠系膜的占比高于直疝、股疝（

0.05）。根据疝囊颈与腹壁下动脉的关系，MSCT冠状位扫描对腹股沟疝的诊断准确率最高。

结论

MSCT对腹股沟疝术前鉴别诊断的灵敏度及特异度较高，且结合疝囊内容物及疝囊颈与腹壁下动脉的关系可提高MSCT对分型诊断的准确性。

Abstract

Objective

To analyze the application value of multi-slice spiral CT （MSCT） in the preoperative diagnosis and classification of inguinal hernia.

Methods

The clinical data of 130 patients with inguinal hernia admitted to our hospital were collected，and all patients underwent inguinal hernia repair.MSCT examination was conducted for the inguinal hernia of the patients，and the efficacy of MSCT in the diagnosis of different types of inguinal hernia was explored by taking the intraoperative diagnosis results as the gold standard. The contents of the hernia sac in patients with different types of inguinal hernia were analyzed，and the accuracy of MSCT under different scanning directions on the relationship between neck of hernia sac and inferior epigastric artery was analyzed.

Results

The intraoperative diagnosis results confirmed that there were 92 cases of oblique hernia，26 cases of direct hernia and 12 cases of femoral hernia among 130 patients with inguinal hernia. A total of 139 hernia sacs were present， with 121 unilateral and 9 bilateral hernia sacs. Among patients with oblique hernias，87 cases were unilateral and 5 cases were bilateral； among patients with direct hernias，23 cases were unilateral and 3 cases were bilateral； among patients with femoral hernias，11 cases were unilateral and 1 case was bilateral.The MSCT scan results showed that patients with oblique hernia，direct hernia and femoral hernia were 92 cases，26 cases and 12 cases respectively. The sensitivities of MSCT in diagnosing oblique hernia，direct hernia and femoral hernia were 95.65%，84.62% and 100% respectively，and the specificities were 89.47%，96.15% and 100% respectively.The contents of the hernia sac in oblique hernia were mainly small intestine and mesentery，while those in direct hernia and femoral hernia were mainly small intestine and fat. The proportions of fat and bladder in the contents of the hernia sac of direct hernia were higher than those of oblique hernia and femoral hernia （

0.05）. The proportion of mesentery in the contents of the hernia sac of oblique hernia was higher than that of direct hernia and femoral hernia （

0.05）.According to the relationship between hernia sac neck and inferior epigastric artery，the diagnostic accuracy of inguinal hernia by MSCT under coronal scan was the highest.

Conclusion

The sensitivity and specificity of MSCT in the preoperative differential diagnosis of inguinal hernia are relatively high，and the accuracy of MSCT in classification diagnosis can be improved if combined the contents of the hernia sac and the relationship between the hernia sac neck and inferior epigastric artery.

关键词

Keywords

references

Perez AJ ， Campbell S . Inguinal hernia repair in older persons ［J］. J Am Med Dir Assoc ， 2022 ， 23 （ 4 ）： 563 - 567 . doi： 10.1016/j.jamda.2022. 02.008 http://dx.doi.org/10.1016/j.jamda.2022.02.008 .

Guillaumes S ， Juvany M . Inguinal hernia repairs performed for recurrence in Spain：population-based study of 16 years and 1，302，788 patients ［J］. Hernia ， 2022 ， 26 （ 4 ）： 1023 - 1032 . doi： 10.1007/s10029-022-02630-w http://dx.doi.org/10.1007/s10029-022-02630-w .

Gram-Hanssen A ， Christophersen C ， Rosenberg J . Results from patient-reported outcome measures are inconsistently reported in inguinal hernia trials：a systematic review ［J］. Hernia ， 2022 ， 26 （ 3 ）： 687 - 699 . doi： 10.1007/s10029-021-02492-8 http://dx.doi.org/10.1007/s10029-021-02492-8 .

Bodilsen A ， Brandsborg S ， Friis-Andersen H . Recurrence and complications after sliding inguinal hernia repair ［J］. Hernia ， 2022 ， 26 （ 4 ）： 1047 - 1052 . doi： 10.1007/s10029-022-02633-7 http://dx.doi.org/10.1007/s10029-022-02633-7 .

Kara H ， Arikan AE ， Dülgeroğlu O ， et al . Management of occult contralateral inguinal hernia：diagnosis and treatment with laparoscopic totally extra peritoneal repair ［J］. Surg Laparosc Endosc Percutan Tech ， 2020 ， 30 （ 3 ）： 245 - 248 . doi： 10.1097/SLE.0000000000000765 http://dx.doi.org/10.1097/SLE.0000000000000765 .

Piga E ， Zetner D ， Andresen K ， et al . Imaging modalities for inguinal hernia diagnosis：a systematic review ［J］. Hernia ， 2020 ， 24 （ 5 ）： 917 - 926 . doi： 10.1007/s10029-020-02189-4 http://dx.doi.org/10.1007/s10029-020-02189-4 .

Shemyatovsky KA ， Azimov RH ， Alekhin AI ， et al . Computed tomography options in the evaluation of hernia repair outcomes using "titanium silk" mesh implants ［J］. J Tissue Eng Regen Med ， 2020 ， 14 （ 5 ）： 684 - 689 . doi： 10.1002/term.3029 http://dx.doi.org/10.1002/term.3029 .

中华医学会外科学分会疝与腹壁外科学组，中国医师协会外科医师分会疝和腹壁外科医师委员会 . 成人腹股沟疝诊断和治疗指南（2018年版）［J］. 中华外科杂志， 2018 ， 56 （ 7 ）： 495 - 498 . doi： 10.3760/cma.j.issn.0529-5815.2018.08.002 http://dx.doi.org/10.3760/cma.j.issn.0529-5815.2018.08.002 .

Gudigopuram SVR ， Raguthu CC ， Gajjela H ， et al . Inguinal hernia mesh repair：the factors to consider when deciding between open versus laparoscopic repair ［J］. Cureus ， 2021 ， 13 （ 11 ）： e19628 . doi： 10.7759/cureus.19628 http://dx.doi.org/10.7759/cureus.19628 .

任杰，黄博 . 老年腹股沟疝特点及手术方式研究进展［J］. 安徽医药， 2022 ， 26 （ 9 ）： 1697 - 1701 . doi： 10.3969/j.issn.1009-6469. 2022.09.001 http://dx.doi.org/10.3969/j.issn.1009-6469.2022.09.001 .

刘石龙，杨加磊，逯景辉 . 腹腔镜时代老年腹股沟疝的治疗策略［J］. 腹腔镜外科杂志， 2022 ， 27 （ 3 ）： 206 - 209 . doi： 10.13499/j.cnki.fqjwkzz.2022.03.206 http://dx.doi.org/10.13499/j.cnki.fqjwkzz.2022.03.206 .

Xu Y ， Qiao Z ， Yin S ， et al . The diagnostic value of MSCT multidirectional imaging in obturator hernia ［J］. Asian J Surg ， 2023 ， 46 （ 5 ）： 2064 - 2066 . doi： 10.1016/j.asjsur.2022.11.022 http://dx.doi.org/10.1016/j.asjsur.2022.11.022 .

Wang F ， Yang XF . Application of computer tomography-based 3D reconstruction technique in hernia repair surgery ［J］. World J Clin Cases ， 2020 ， 8 （ 23 ）： 5944 - 5951 . doi： 10.12998/wjcc.v8.i23.5944 http://dx.doi.org/10.12998/wjcc.v8.i23.5944 .

杨娅，蒋锐，肖瑜，等 . 多层螺旋CT在腹股沟疝患者手术中的临床意义［J］. 川北医学院学报， 2021 ， 36 （ 12 ）： 1645 - 1648 . doi： 10.3969/j.issn.1005-3697.2021.12.026 http://dx.doi.org/10.3969/j.issn.1005-3697.2021.12.026 .

潘银梅，高谞杰 . 多层螺旋CT对腹股沟疝的分型鉴别及应用价值［J］. 中华疝和腹壁外科杂志（电子版）， 2022 ， 16 （ 2 ）： 158 - 161 . doi： 10.3877/cma.j.issn.1674-392X.2022.02.006 http://dx.doi.org/10.3877/cma.j.issn.1674-392X.2022.02.006 .

Ganesan G ， Ramachandran R ， Raji VBR ， et al . A radiological review of the unusual contents of inguinal region ［J］. Indian J Radiol Imaging ， 2023 ， 33 （ 3 ）： 373 - 381 . doi： 10.1055/s-0043-1764404 http://dx.doi.org/10.1055/s-0043-1764404 .

占海生，曹俊杰 . 多层螺旋CT结合血清C反应蛋白对腹股沟嵌顿疝患者的诊断价值［J］. 中华疝和腹壁外科杂志（电子版）， 2022 ， 16 （ 1 ）： 70 - 73 . doi： 10.3877/cma.j.issn.1674-392X.2022.01.016 http://dx.doi.org/10.3877/cma.j.issn.1674-392X.2022.01.016 .

王中魁 . 成人隐匿性腹股沟疝的诊疗进展［J］. 中国微创外科杂志， 2021 （ 7 ）： 648 - 651 . doi： 10.3969/j.issn.1009-6604.2021.07.014 http://dx.doi.org/10.3969/j.issn.1009-6604.2021.07.014 .

Caserta NMG ， Penachim TJ ， Contardi EB ， et al . Contents of the inguinal canal：identification by different imaging methods ［J］. Radiol Bras ， 2021 ， 54 （ 1 ）： 56 - 61 . doi： 10.1590/0100-3984.2020.0006 http://dx.doi.org/10.1590/0100-3984.2020.0006 .

章家强，蔡亲磊，詹兴云 . 腹股沟斜疝、直疝及股疝的多排螺旋CT影像学特征及鉴别诊断价值［J］. 中华疝和腹壁外科杂志（电子版）， 2021 ， 15 （ 3 ）： 243 - 247 . doi： 10.3877/cma.j.issn.1674-392X. 2021.03.008 http://dx.doi.org/10.3877/cma.j.issn.1674-392X.2021.03.008 .

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