多层螺旋CT小肠造影与双气囊小肠镜在不明原因腹痛诊断中的价值

The value of multi-slice spiral CT enterography and double-balloon enteroscopy in the diagnosis of unexplained abdominal pains

目的:评价多层螺旋CT小肠造影(MSCTE)与双气囊小肠镜(DBE)在不明原因腹痛患者诊断中的价值。方法:41例不明原因腹痛患者,同时行MSCTE和DBE检查,结合内镜和(或)手术病理、临床随访等,比较两者对不明原因腹痛病因的检出率、诊断准确率。结果:MSCTE和DBE的病变检出率分别为63.41%(26/41)和87.80%(36/41);诊断准确率分别为70.73%(29/41)和92.68%(38/41)。结论:DBE对不明原因腹痛患者的病变检出率、诊断准确率均高于MSCTE;MSCTE对小肠肿瘤、克罗恩病有一定的定位、定性诊断价值;MSCTE可作为DBE检查前筛选性检查,对DBE进镜方式选择提供有效的帮助。

Objective To assess the value of multi-slice spiral CT enterography （MSCTE） and double- balloon enteroscopy （DBE） in the diagnosis of unexplained abdominal pains. Methods 41 patients with unexplained abdominal pains were selected and received MSCTE and DBE examination. With combining the results of endoscopy and/or surgical pathology, clinical follow-ups, the differences in pathological detection rate and diagnostic accuracy between these two measures were compared. Results The detection rates of MSCTE and DBE were 63.41% （26/41） and 87.80% （36/41）, and the diagnostic accuracies were 70.73% （29/41） and 92.68% （38/41 ）, respectively. Conclusion The detection rate and diagnostic accuracy of DBE were both higher than those of MSCTE. MSCTE could facilitate the diagnosis of small bowel tumor and Crohn＇s disease, with positioning and qualitative value. MSCTE could be a pre-test to help decide the appropriate way of DBE insertion.