胃部疾病仿真内镜与纤维胃镜的对比研究

Virtual Endoscopy of the Stomach in Patients with Suspected Gastric Disease:Comparison with Fibrogastroscopy

目的 研究螺旋ＣＴ仿真内镜诊断胃组疾病的临床价值。方法 ２７ 名可疑胃部疾病的患者在禁食禁水至少４ 小时，口服产气剂后立即进行上腹部螺旋ＣＴ扫描。在计算机工作站用预置的软件重建出仿真内镜图像。所有病人在ＣＴ扫描后１ 天之内进行了纤维胃镜检查；螺旋ＣＴ 仿真内镜的诊断结果与纤维胃镜的结果进行比较。结果 螺旋ＣＴ仿真内镜正确地诊断所有的正常胃（ｎ ＝ ６） 和胃息肉（ｎ ＝ ５） 的病例，１０ 个胃溃疡（１０／１２） 和３ 个胃癌（３／４） 的病人被ＣＴ 仿真内镜诊断，其所见与纤维胃镜检查相似；但是２ 个浅小息肉和１ 例胃底癌于ＣＴ 仿真内镜被漏诊。结论 螺旋ＣＴ仿真内镜是一种新的非创伤性检查技术，在采用合适的检查体位和胃部适度扩张的条件下可以成为胃部疾病的一种有效的检查方法。

Objective To determine the value of spiral CT Virtual Endoscopy in patients with suspected gastric diseases.Methods 27 patients with suspected gastric diseases underwent single breath hold upper abdominal helical CT acquisition after fasting for at least four hours and administration of bubble agent.With prototype software,Virtual Endoscopic imagings were reconstructed in the workstation.All patients underwent gastroscopy within one day.The findings at CT gastroscopy were compared with the findings at real gastroscopy and biopsy.Results With the helical CT Virtual Gastroscopy,all the patients with normal stomach ( n =6) and the patients with polyp ( n =5) were correctly diagnosed,10 patients (10/12) with gastric peptic ulcer and three patients (3/4) with gastric tumor were diagnosed,and the findings at CT Virtual gastroscopy were grossly in agreement with the findings at real gastroscopy.But two shallow ulcers,two small flat polyps and one carcinoma in the gastric fundus were missed at the CT Virtual gastroscopy.Conclusion The helical CT gastroscopy is a new and noninvasive technique,can be a useful tool for the evaluation of the gastric pathologies in the condition of the appropriate posture and sufficient distend of the stomach. [