64层螺旋CT在结肠病变中的临床应用价值

Clinical application of 64-slice spiral CT in the diagnosis of colonic diseases

目的:探讨64层螺旋CT三维重建与仿真肠镜在结肠病变诊断中的应用价值。方法:应用Siemens Somatom 64层螺旋CT对83例患者行一次屏气全结肠容积扫描,并利用工作站进行后处理以获取CT仿真肠镜(CTVC),多平面重建(MPR),表面阴影成像(SSD)和透明显示(Raysum)图像,并结合原始横断面等图像进行分析,并与结肠镜或术后病理对照。结果:CTVC检出14例结肠镜确诊为正常结肠中的13例,1例误诊为结肠息肉。CTVC检出37例结直肠癌中的34例,敏感度为91.89%,特异度为92.86%,假阳性率为7.14%,假阴性率为8.11%。CTVC检出21例42枚结直肠息肉中38枚,敏感度为90.48%,特异度为92.86%,假阳性率为7.14%,假阴性率为9.52%。还包括:家族性腺瘤性息肉病2例,溃疡性结肠炎2例,节段性肠炎1例,子宫内膜异位1例,肠梗阻5例。结论:64层螺旋CT三维重建及仿真内镜对结直肠病变的诊断有其独特的优越性,为临床提供比纤维结肠镜更丰富的信息,很有必要广泛应用于临床。

Objective：To investigate the value of Siemens Sematom 64-slice CT of imaging and virtual colonoscopy in the diagnosis of colonic diseases.Metheds： The volume scan of 64-slice spiral CT pneumoclon was performed in whole colorectum of 83 cases, then data was transmitted to the work station, cr virtual colonography （CTVC）, multiplanar reconstruction （MPR）, 3D surface shaded display （SSD）, raysum were performed respectively. Combined with the original axial section. The results were compared with the fmdings of colonoscopy or postoperative pathology. Results： 14 cases were found normal by EC, one case of them was misdiagnosed as polyp by 64- slice CT. Sensitivity, specificity, false positive proportion and false negative proportion for detection of eolorectal carcinoma were 91.89%, 92.86%, 7.14% and 8.11%, respectively. Sensitivity, specificity, false positive propertion and false negative proportion for detection of colorectal polyps were 90.48%, 92.86%, 7.14% and 9.52% ,respectively. It also included： familial adenomatons polyposis （n= 2）, ulcerative colitis （n= 2）, chronic colitis （n= 1）, endometriosis （n= 1）, colon obstruction （n= 5）. Conduslon：64- slice spiral CT 3D-recomtrctive images and virtual colonoscopy plan an unique role in the diagnosis of colorectal diseases, which can give us mere information than that of fiberoptie colonoscopy. Extensively, clinical application is recommended.