Abstract：
OBJECTIVE: To investigate the differences in the visibility and size of abdominal wall hernias in computed tomography (CT) with and without Valsalva maneuver.
METHODS: This single-center retrospective study included consecutive patients who underwent abdominal CTs with Valsalva maneuver between January 2018 and January 2022. Inclusion criteria was availability of an additional non-Valsalva CT within 6 months. A combined reference standard including clinical and surgical findings was used. Two independent, blinded radiologists measured the hernia sac size and rated hernia visibility on CTs with and without Valsalva. Differences were tested with a Wilcoxon signed rank test and McNemar\'s test.
RESULTS: The final population included 95 patients (16 women; mean age 46 ± 11.6 years) with 205 hernias. Median hernia sac size on Valsalva CT was 31 mm compared with 24 mm on non-Valsalva CT (p < 0.001). In 73 and 82% of cases, the hernias were better visible on CT with Valsalva as compared to that without. 14 and 17% of hernias were only visible on the Valsalva CT. Hernia visibility on non-Valsalva CT varied according to subtype, with only 0 and 3% of umbilical hernias not being visible compared with 43% of femoral hernias.
CONCLUSIONS: Abdominal wall hernias are larger and better visible on Valsalva CT compared with non-Valsalva CT in a significant proportion of patients and some hernias are only visible on the Valsalva CT. Therefore, this method should be preferred for the evaluation of abdominal wall hernias.
METHODS: This single-center retrospective study included consecutive patients who underwent abdominal CTs with Valsalva maneuver between January 2018 and January 2022. Inclusion criteria was availability of an additional non-Valsalva CT within 6 months. A combined reference standard including clinical and surgical findings was used. Two independent, blinded radiologists measured the hernia sac size and rated hernia visibility on CTs with and without Valsalva. Differences were tested with a Wilcoxon signed rank test and McNemar\'s test.
RESULTS: The final population included 95 patients (16 women; mean age 46 ± 11.6 years) with 205 hernias. Median hernia sac size on Valsalva CT was 31 mm compared with 24 mm on non-Valsalva CT (p < 0.001). In 73 and 82% of cases, the hernias were better visible on CT with Valsalva as compared to that without. 14 and 17% of hernias were only visible on the Valsalva CT. Hernia visibility on non-Valsalva CT varied according to subtype, with only 0 and 3% of umbilical hernias not being visible compared with 43% of femoral hernias.
CONCLUSIONS: Abdominal wall hernias are larger and better visible on Valsalva CT compared with non-Valsalva CT in a significant proportion of patients and some hernias are only visible on the Valsalva CT. Therefore, this method should be preferred for the evaluation of abdominal wall hernias.
摘要：
目的：研究有无Valsalva动作的计算机断层扫描（CT）中腹壁疝的能见度和大小的差异。
方法：这项单中心回顾性研究包括2018年1月至2022年1月期间接受Valsalva手法腹部CT检查的连续患者。纳入标准是在6个月内可获得额外的非ValsalvaCT。使用包括临床和手术发现的组合参考标准。两个独立的，失明的放射科医师在有和没有Valsalva的CT上测量了疝囊大小和评估的疝可见性.差异用Wilcoxon符号秩检验和McNemar检验进行测试。
结果：最终人群包括95名患者（16名女性；平均年龄46±11.6岁），205例疝气。与非ValsalvaCT的24mm相比，ValsalvaCT的平均疝囊大小为31mm（p<0.001）。在73%和82%的病例中，与没有Valsalva的CT相比，使用Valsalva的疝气在CT上更明显。仅在ValsalvaCT上可见14％和17％的疝。非ValsalvaCT上的疝可见性根据亚型而变化，与43％的股疝相比，只有0％和3％的脐疝不可见。
结论：与非ValsalvaCT相比，在ValsalvaCT上的腹壁疝较大且较好地可见，在相当比例的患者中，一些疝仅在ValsalvaCT上可见。因此,腹壁疝的评价应首选此方法。
方法：这项单中心回顾性研究包括2018年1月至2022年1月期间接受Valsalva手法腹部CT检查的连续患者。纳入标准是在6个月内可获得额外的非ValsalvaCT。使用包括临床和手术发现的组合参考标准。两个独立的，失明的放射科医师在有和没有Valsalva的CT上测量了疝囊大小和评估的疝可见性.差异用Wilcoxon符号秩检验和McNemar检验进行测试。
结果：最终人群包括95名患者（16名女性；平均年龄46±11.6岁），205例疝气。与非ValsalvaCT的24mm相比，ValsalvaCT的平均疝囊大小为31mm（p<0.001）。在73%和82%的病例中，与没有Valsalva的CT相比，使用Valsalva的疝气在CT上更明显。仅在ValsalvaCT上可见14％和17％的疝。非ValsalvaCT上的疝可见性根据亚型而变化，与43％的股疝相比，只有0％和3％的脐疝不可见。
结论：与非ValsalvaCT相比，在ValsalvaCT上的腹壁疝较大且较好地可见，在相当比例的患者中，一些疝仅在ValsalvaCT上可见。因此,腹壁疝的评价应首选此方法。
