Abstract: Objective To explore the clinical significance of three-dimensional simulation imaging based pneumoperitoneum CT in the diagnosis of postoperative abdominal adhesion. Methods 826 patients with unexplained chronic abdominal pain or recurrent mechanical small bowel obstruction after abdominal operation were selected.The clinical diagnosis was obtained by the use of three-dimensional simulation imaging of pneumoperitoneum CT obtained by manual scanning and assisted by laparoscopy. Results Pneumoperitoneum CT examination based on volume rendering method(volume render，VR) could realize three-dimensional imaging of peritoneal cavity and simulate the morphological characteristics of peritoneal cavity.In the 826 cases of pneumoperitoneum CT examination,602 cases showed abnormal abdominal wall suspension structure through pneumoperitoneum space and counterweight displacement,which was diagnosed as abdominal adhesion and confirmed by laparoscopy.Among the 224 cases without adhesions,12 cases with simple visceral adhesions were found by laparoscopy.The sensitivity and specificity of pneumoperitoneum CT were 96.5% and 100%,respectively. Conclusion The three-dimensional imaging of peritoneal cavity obtained by pneumoperitoneum CT could directly show the existence of abdominal wall adhesion or not,but has poor correlation with visceral adhesion,which had a certain effect of replacing laparoscopic examination.

Key words: abdominal surgery, abdominal adhesion, recurrent mechanical small bowel obstruction, chronic abdominal pain, artificial pneumoperitoneum CT, volume rendering, peritoneal imaging, laparoscopy