MDCT多平面重组技术诊断肠息肉与内镜对比分析

The Comparative Study of Multidetector Spiral CT Reconstruction and Endoscope in Diagnosing Polyp Intestinal

目的探讨多排螺旋CT(MDCT)对肠息肉的显示情况及良恶性诊断正确性。资料与方法经病理证实的33例(按解剖部位共54例)肠息肉患者均行内镜及MDCT平扫和双期增强扫描,回顾性分析并比较两种检查对不同部位肠息肉的检出情况和MDCT对肠息肉良恶性的诊断情况。结果 MDCT共检出肠息肉54例,其中小肠3例(均位于空肠),结肠38例(升结肠回盲部6例,横结肠4例,降结肠9例,乙状结肠19例),直肠13例。CT拟诊良性46例,恶性8例,病理证实5例恶变,恶性诊断正确率为62.5%(5/8)。内镜共检出48例,3例胃癌术后吻合口远端空肠小息肉均漏诊,1例回盲部小息肉、2例直肠远端小息肉均漏诊。结论 MDCT多平面重组图像结合双期增强薄层轴位图像能准确检出不同解剖部位的肠息肉,对肠息肉的检出优于内镜;对预测息肉有无恶变及随访复查有重要的临床价值。

Objective To investigate the value of multidetector Spiral CT（MDCT）in diagnosing polyp intestinal.Materials and Methods 33 cases with polyp intestinal（54 cases by anatomic site）proved by pathology received endoscope and plain and two-phase enhanced MDCT scan.Detection of polyp intestinal and diagnostic accuracy of benign or malignant by two examinations were analyzed and compared respectively.Results Among 54 cases with polyp intestinal detected by MDCT,there were 3 cases with polyp intestinal in small intestine（all in jejunum）;38 cases in colon（6 in ascending colon and junction,4 in transverse colon,9 in descending colon,19 in sigmoid colon）;13 cases in rectum.There were 46 cases with polyp intestinal were benign and 8 cases were malignant by MDCT,while 5 were confirmed by pathology,the diagnostic accuracy of malignant was 62.5%.48 cases were detected by endoscope,3 cases with small jejunum polyp in distal end of stoma after gastric carcinoma were missed,1 case with small polyp in ileocecal junction and 2 cases with small polyp in rectum were missed by endoscope.Conclusion MPR images combined with two-phase enhanced MDCT axial images can exactly detect polyp intestinal in different anatomic site,which has an advantage over endoscope and it has great clinical value in predicting canceration and follow up of polyp intestinal.