口服等渗甘露醇螺旋CT肠造影对小肠肿瘤的诊断应用

Utility of spiral CT enterography with orally administrated isotonic mannitol in diagnosing small bowel tumors

目的评价口服大剂量2.5%等渗甘露醇螺旋CT小肠造影(SCTE)在小肠肿瘤诊断中的价值。方法 36例经手术病理证实小肠肿瘤患者每人口服2.5%等渗甘露醇约1000～1500 mL后,肌注20 mg山莨菪碱注射液,10～15 min后行螺旋CT三维扫描,分析不同小肠肿瘤的表现,并比较42例常规CT扫描与SCTE的诊断结果。结果 36例患者除2例回盲部充盈欠佳外,其余34例十二指肠,空肠及回肠肠腔充盈良好,对肿瘤的显示、衬托满意。SCTE检查与临床诊断符合率为94.4%(34/36),高于常规扫描78.57%(33/42)。结论 SCTE是一种简便、安全、非侵袭性,有效评价小肠肿瘤的方法,能明显提高肿瘤的检出率。

Objective To evaluate the utility of spiral computed tomography enterography（SCTE） with orally administrated large dose of 2.5% isotonic mannitol in diagnosing small bowel tumors（SBT）.Methods Thirty-six patients with surgically and pathologically proved SBT underwent SCTE.All the procedures were performed by using three dimensional（3D） spiral CT scans of the abdomen at 10～15 minutes after orally administrated 1000-1500 mL of 2.5% isotonic mannitol and then intramuscularly injected 20 mg anisodamine for each case.The CT findings of all SBT patients were retrospectively analyzed and compared with those of 42 patients who underwent traditional CT scans.Results Among 36 patients,except the ileocecal lumen filling in 2 cases was unsatisfactory,remainder duodenal-,jejunal-and ileal lumina in 34 cases were sufficiently filled by contrast agents and benefited to visualize SBTs.The corresponding rate of SCTE in comparing with clinically known result was 94.4%（34/36） which was higher than 78.57%（33/42） of traditional CT scans.Conclusion SCTE used for diagnosing SBT is a simple,safe,noninvasive and effective modality which could significantly elevate the detection rate.