MSCT小肠造影与消化内镜联合诊断炎症性肠病的价值

Application Value of MSCT Enterography Combined with DigestiveEndoscopy in the Diagnosis of Inflammatory Bowel Disease

目的研究多层螺旋计算机体层成像(MSCT)小肠造影与消化内镜联合诊断炎症性肠病的应用价值。方法选取2018年2月至2021年1月郑州人民医院98例疑似炎症性肠病患者,均采用MSCT小肠造影和消化内镜检查,以病理活检结果为金标准,统计MSCT小肠造影和消化内镜单独诊断和联合诊断的诊断结果和诊断效能,分析MSCT小肠造影和消化内镜单独诊断和联合诊断不同类型炎症性肠病和炎症性肠病病变的检出率。结果本组98例疑似炎症性肠病患者中,经病理活检确诊阳性71例,阴性27例;MSCT小肠造影诊断出真阳性49例,真阴性15例;消化内镜诊断出真阳性40例,真阴性16例;二者联合诊断出真阳性67例,真阴性13例;二者联合诊断的灵敏度、准确度较MSCT小肠造影诊断和消化内镜诊断高,漏诊率较MSCT小肠造影诊断和消化内镜诊断低(P<0.05);二者联合诊断克罗恩病、溃疡性结肠炎检出率较MSCT小肠造影诊断和消化内镜诊断高(P<0.05);二者联合诊断多节段病变、肠腔狭窄、肠壁溃疡检出率较MSCT小肠造影诊断和消化内镜诊断高(P<0.05)。结论MSCT小肠造影与消化内镜联合诊断炎症性肠病能提升诊断灵敏度、特异度和准确度,减少漏诊和误诊情况的发生,且二者联合可确定疾病类型,为临床制定治疗方案提供指导。

Objective To study the diagnostic value of multislice spiral computed tomography(MSCT)enterography and digestive endoscopy in the diagnosis of inflammatory bowel disease.Methods From February 2018 to January 2021,a total of 98 patients with suspected inflammatory bowel disease in Zhengzhou People’s Hospital were selected,and all of them were examined by MSCT enterography and digestive endoscopy.Using the pathological biopsy results as the“gold standard”,the diagnostic results and diagnostic efficacy of MSCT enterography and digestive endoscopy alone and in combination were analyzed.The detection rates of different types of inflammatory bowel disease and inflammatory bowel disease were analyzed by MSCT enterography and digestive endoscopy alone and in combination.Results Among 98 patients with suspected inflammatory bowel disease,71 cases were positive and 27 cases were negative.A total of 49 cases were true positive and 15 were true negative by MSCT enterography.A total of 40 cases were true positive and 16 cases were true negative by digestive endoscopy.A total of 67 cases were true positive and 13 cases were true negative by combination of the two.The sensitivity and accuracy of the combined diagnosis were higher than those of MSCT enterography and digestive endoscopy,and the missed diagnosis rate of the combined diagnosis were lower than those of MSCT enterography and digestive endoscopy(P<0.05).The detection rate of combined diagnosis of Crohn’s disease and ulcerative colitis was higher than that of MSCT enterography and digestive endoscopy(P<0.05).The detection rate of combined diagnosis of multi-segmental lesions,intestinal stenosis and intestinal wall ulcer was higher than that of MSCT enterography and digestive endoscopy(P<0.05).Conclusion The combination of MSCT enterography and digestive endoscopy in the diagnosis of inflammatory bowel disease can improve the sensitivity,specificity and accuracy of diagnosis,reduce the occurrence of missed diagnosis and misdiagnosis,and the combination of the two can determine the type of disease and provide guidance for clinical treatment.