MDCT小肠造影受检者体位的优选

Optimization of Patient's Different Position in 256 Multidetector - row Computed Tomography Enterography

目的评价多层螺旋CT小肠造影最佳体位选择。方法 60例受检者口服对比剂充盈胃和小肠,随机分为2组:35例采取俯卧位,25例采取仰卧位。患者在60分钟内分4次口服总量2000ml 2.5%等渗甘露醇溶液,行256-多层螺旋CT小肠造影(MDCTE),平扫结束后行增强扫描,通过横断面及多平面重建,测量肠腔宽度、肠壁厚度,对各组测量及评价结果进行统计学分析。结果在肠腔宽度、肠壁厚度方面,者二组无明显差异;49例小肠充盈程度为满意-较满意的受检者,俯卧位明显优于仰卧位;肠管分布、显示病变等方面,俯卧位也优于仰卧位。结论小肠MDCT造影行俯卧位检查更有助于小肠疾病的临床诊断。

Objective To evaluate which position of the patient can fully distend the intestinal canal and demonstrate the enteric cavity and intestinal wall in 256 Multidetector - row computed tomography enterography (MDCTE),through patients who present unknown cause digestive tract hemorrhage,abdominal pain,suspected that the small intestine pathological change.Methods 60 patients suspected small bowel diseases were collected from June to August 2011,oral administration 2.5%of mannitol 2000ml within four times in 60 minutes.256 - MDCTE was used to diagnose the pathological change of these patients.After MDCT plain scanning,enhancement scanning(CTA and CTV ) was performed.The width of the enteric cavity and thickness of the intestinal wall measured through the transverse section and multi-planar reconstruction(MPR) were statistically analyzed.Results Among 60 patients,35 cases with prone position,25 cases with supine position.No significant differences in sensitivity,specificity,and accuracy were observed between prone and supine position regarding the following parameters at the patient level;bowel wall thickening,bowel wall enhancement,enteroenteric fistulas,detection of abdominal nodes,and perivisceral fat enhancement.Supine position was significantly superior compared to prone position in demonstrating intestinal distribution.Conclusions Prone and supine positions are equally accurate to assess disease activity and bowel damage.Prone position may be superior to CT in demonstrating intestinal distribution. Prone position in MDCTE is one of reliable diagnostic method in diagnosis the small bowel disease.