CT仿真内镜与双对比造影诊断小肠隆起性病变的价值

Computed tomographic virtual endoscopy versus double contrast examination in diagnosing small intestine protuberant lesions

由于小肠曲折冗长，一直缺乏有效检查手段。小肠病变以隆起性病变为主，目前影像学检查以小肠双对比造影为主，近年随着多螺旋CT的广泛应用，CT仿真内镜在空腔脏器的应用越来越广泛，两者的价值比较需要进一步明确。目的：评价CT仿真内镜与双对比造影检查在诊断小肠隆起性病变的价值。方法；取离体猪小肠标本，于内壁模拟大小分别〈5mm及5-10mm，10-15mm类圆形隆起性病变，先行多层螺旋CT扫描，利用工作站进行CT仿真内镜成像，然后进行小肠气钡双对比造影检查。由资深医生采用单盲法评价诊断，比较两种方法的诊断自信度及正确率。结果与结论：对标本〈5mm组的病变，小肠双对比造影技术的自信度级别优于CT仿真内镜技术，差异有显著性意义（Pc0．05）。而较大病变的小肠息肉，两种诊断方法的自信度差异无显著性意义（P〉0．05）。CT仿真内镜与小肠双对比造影检奁对小肠隆起性病变的诊断各有优势，综合运用可以提高诊断正确率。

BACKGROUND： Due to the long and winding characteristics of small intestine, the examination technique is ineffective. The lesions of small intestine are mainly protuberant. At present, double contrast examination is chiefly applied in imaging examination In the recent years, with the wide application of multi-slice spiral computed tomography （CT）, CT virtual endoscopy （CTVE） gets more and more used in hollow organ. The value of the two techniques needs a comparison to make it clearer. OBJECTIVE： To evaluate the value of CTVE and double contrast examination in diagnosing small intestine pprotuberant lesions. METHODS： Isolated porcine small intestines were taken as samples. MSCT scanned the quasi circular protuberant Lesions whose simulated heights of the intestinal wall were 1-5 mm, 5-10 mm and 10-15 mm. CTVE imaging was made through work station. Then we made small intestinal air-barium double contrast examination. The experienced physician compared the diagnostic self-confidence and accuracy between the two methods by single-blind evaluation. RESULTS AND CONCLUSION： To the protuberant lesions less than 5 rnm, the doctors were more confident in diagnosing by double contrast examination of small intestine than by CTVE. The diagnostic accuracy of the two methods has no statistic differences. CTVE and double contrast examination each have their advantages in diagnosing protuberant lesions of small intestine. The diagnostic accuracy can be improved by comprehensive application.