目的探讨64层螺旋CT对消化道 穿孔部位的诊断价值。方法 回顾分析经 手术证实的75例消化道穿孔患者的CT表 现。结果 75例患者中，胃穿孔35例，小 肠穿孔31例，6例为阑尾炎穿孔，2例结肠 癌穿孔，1例结肠憩室穿孔。主要64层螺 旋CT征象：腹腔游离气体量及发布，腹 腔积液，腹膜炎改变。结论 64层螺旋CT 对消化道穿孔的准确率较高，通过腹腔气 体、腹腔积液、腹膜炎改变对推断消化道 穿孔部位具有较高诊断价值。

Objective To inquire into the diagnostic value of the 64-slice spiral CT on the position of gastrointestinal perforation. Methods CT manifestation of 75 cases with gastrointestinal perforation proved by surgery were retrospectively analyzed. Results 75 cases included 35 gastric perforation, 31 intestinal perforation, 6 perforated appendicitis, 2 colon cancer perforation, 1 colonic diverticulum perforation. The main 64-slice spiral CT signs were as follows: the volume and distribution of intra-abdominal free gas, peritoneal effusion and peritonitis. Conclusion It was 64-slice spiral CT that owed a higher accuracy rate in diagnosing gastrointestinal perforation, the charges of intra-abdominal free gas, peritoneal effusion and peritonitis were of great value on deducing the position of gastrointestinal perforation as well.