目的 探讨多层螺旋CT增强扫 描对急腹症的诊断价值。方法 116例手 术或临床证实的急腹症患者行64排螺旋 CT平扫加增强扫描，数据传至工作站进 行重建及观察，方法包括多平面重组 (MPR)、最大密度投影(MIP)及容积再现 (VR)。结果 116例患者中，肠道病变42 例，平扫诊断正确18例，增强扫描诊断 正确22例；外伤16例，平扫诊断正确12 例，增强扫描诊断正确16例；急性胰腺 炎16例，平扫诊断正确12例，增强扫描 诊断正确12例；泌尿系结石14例，平扫 诊断正确14例，增强扫描诊断正确14 例；血管病变12例，平扫诊断正确4例， 增强扫描诊断正确12例；胆道结石10 例，平扫诊断正确9例，增强扫描诊断 正确9例。结论 平扫与增强扫描在急性 胰腺炎和结石类病变诊断中差别不大， 对于血管病变、肠道病变及外伤中的诊 断，增强扫描正确率明显高于平扫，增 强扫描在急腹症诊断中具有重要的临床 应用价值，值得在基层医院大力推广。

Objective To investigate the diagnostic value of multislice spiral CT enhanced scan of the abdomen. Methods 116 cases of acute abdomen underwent 64 slice spiral CT scan and enhanced scan, data were transferred to workstation for reconstruction and observation methods, including multi planar reconstruction (MPR), maximum intensity projection (MIP) and volume rendering (VR). Results In 116 patients, 42 cases of intestinal lesions, plain scan 18 cases were correctly diagnosed, enhanced scan 22 cases were correctly diagnosed. 16 cases of trauma, plain scan 13 cases were correctly diagnosed, enhanced scan 16 cases were correctly diagnosed; 16 cases of acute pancreatitis, plain scan 12 cases were correctly diagnosed, enhanced scan 12 cases were correctly diagnosed; 14 cases of urinary calculi, plain scan 14 cases were correctly diagnosed, enhanced scan 14 cases were correctly diagnosed. 12 cases of vascular lesions, plain scan 5 cases were correctly diagnosed, enhanced scan 12 cases were correctly diagnosed; 10 cases of biliary calculi, plain scan 14 cases were correctly diagnosed, enhanced scan 14 cases were correctly diagnosed. Conclusion The diagnostic value of Plain and enhanced CT scanning in acute pancreatitis and small stones was the same, for the diagnosis of vascular diseases, intestinal diseases and trauma, enhanced accuracy was higher than that of plain scan, enhanced scan has important clinical value in diagnosis of acute abdomen, it is worth popularizing in primary hospitals.