cT仿真结肠内窥镜的临床应用研究

Investigation on clinical application of CT virtual colonoscopy

目的研究ＣＴ仿真结肠内窥镜（ＣＴＶＣ）的检查方法、镜下表现及临床应用价值。方法用螺旋ＣＴ对３１例结肠疾病患者行容积扫描，包括腺癌２５例，腺瘤息肉２例，非何杰金淋巴瘤１例，腺鳞癌１例，多发憩室１例，阑尾粘液囊肿１例。除结肠憩室外，全部病例经病理证实。利用Ｎａｖｉｇａｔｏｒ软件对容积扫描数据进行三维重建，获得仿真结肠内窥镜的影像，应用Ｆｌｙｔｈｒｏｕｇｈ软件沿结肠管腔中轴方向推进观察。结果ＣＴＶＣ可确定直径３～５ｍｍ的憩室和直径６ｍｍ的息肉，对肿物表面细节显示满意，可发现瘤旁子病灶并可观察正常或异常粘膜纹。发现瘤旁子病灶可确定为恶性病变。ＣＴＶＣ对浅表隆起性病变敏感性较差。结论ＣＴＶＣ是一种有效的结肠占位性病变的检查手段。

Objective To investigate the methods, imaging features and clinical value of CT virtual colonoscopy (CTVC). Methods Thirty one patients underwent volume scanning useing helical CT (Hispeed CT/i, GE). The diseases included adenocacinoma 25, adenomatous polyp 2, non Hodgkin's lymphoma 1, adenosquamocarcinoma 1 multiple diverticulum 1 and mucocele of appendix 1. All cases were proved by histology except the one with multiple diverticulum. Volumetric data was acquired, and 3D virtual colonoscopy images were generated from volumetric data using the Navigator soft ware. The CTVC images was observed along the axis of colon using the soft ware, Fly through. Results CTVC correctly demonstrated the detail of surface of masses. It could show the daughter nodules around the main mass, an indication of malignancy, and the normal or abnormal mucosal folds. CTVC had lower sensitivity for flat lesion. Conclusions CTVC has proved to be a non invasive and useful tool in the detection of space occupying lesions of the colon. CTVC has good prospect of clinical application.