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PurposeTo evaluate multislice spiral CT (MSCT) in diagnosing abdominal anaphylactoid purpura (AAP), and to explore its role in treatment follow-up.Materials and Methods Clinical and MSCT data of 13 patients with confirmed AAP were retrospectively analyzed. All patients underwent abdominal CT scan and thin layer reconstruction. Upper endoscopy was performed in 8 patients prior to treatment. MSCT was performed in 10 patients and endoscopy in 4 patients posttreatment, then clinical and CT features were compared to pretreatment findings.Results In pretreatment CT scan, single segment bowel involvement was found in 2 cases, multisegmental bowel involvement in 10 cases, and no positive finding in 1 patient. The duodenum and jejunum were involved in 8 patients and stomach in 5 patients. The diseased bowel wall showed swelling and thickening with decreased attenuation and homogeneous luminal narrowing with equivocal lining and double loop sign. Infiltration was found in 10 patients, small ascites in 3 patients. Patients were misdiagnosed as acute pancreatitis in 2 cases, acute cholecystitis, small bowel obstruction and peritonitis in 1 case respectively. Of 13 patients, five patients were cured, and the other 8 patients were improved. The clinical symptoms including rash, abdominal pain, occult blood, leukocytosis, vomiting, melena, urine occult blood were improved (χ2=5.59-18.33,P0.05).Conclusion MSCT findings of AAP are nonspecific. CT diagnosis is difficult before skin rash. Combining CT characteristics of multisegmental bowel edema and clinical manifestations is helpful. CT examination can effectively follow up treatment response.
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Objective To evaluate the diagnostic value of multi-slice computed tomography (MSCT)for incisional hernia of ab-dominal wall before operations.Methods Thirty patients with incisional hernia in abdominal wall confirmed by the pathology were enrolled in this study.All patients underwent MSCT examination with sagittal and coronal MPRs,and 21 cases underwent ultra-sound (US)examinations.The value of transverse scan and MPRs & MSCT and US on demonstrating the number,location,con-tents of incisional hernia,and accompanying intestinal obstruction or other complications were retrospectively evaluated and com-paired.Results Of 30 cases,there were 40 hernias,the rate of MSCT and US in detecting incisional hernias were 97.5% and 56.0%, respectively.MSCT performed better than US on demonstrating the incisional hernias (P =0.000).On MSCT,there was no signif-icant difference in the detection for isolated incisional hernia between the MPRs and axial scans (P = 1.000 ).However,MPR showed a more accurate rate for two or multiple incisional hernias diagnosis (P =0.006),and the sagittal reconstruction displayed more correct than coronal reconstruction on two or multiple incisional hernias (P =0.01 9).Furthermore,MSCT can exactly reveal the complications of incisional hernias (7 cases of intestinal obstruction,5 cases of intestinal ischemia and edema,and 1 case of me-tastasis in incisional hernia),which were not detected by US.Conclusion MSCT can correctly demonstrate the incisional hernia of abdominal wall and its complication,it can provide important imaging reference for clinical therapy.