CT仿真胃内窥镜的临床应用研究

The research of clinical application of computed tomographic virtual gastroscopy

目的 研究CT仿真胃内窥镜 (computedtomographicvirtualgastroscopy ,CTVG)在胃部病变诊断中的应用价值、检查方法和镜下所见。方法 对 6 9例可疑胃部病变患者行胃不同气量充气后螺旋CT扫描 (准直器宽度 3mm ,螺距 1 2～ 2 5 ,扫描速度 0 8s/ 36 0°) ,以获得容积扫描数据 ,将原始数据进行重叠重建 (重建率 33%～ 6 7% ) ,再利用Navigator软件生成仿真胃内窥镜影像。结果 CTVG的准确性为 92 8% ,敏感性为 96 4% ,特异性为 78 6 %。CTVG对病变形态的显示与纤维胃镜 (fibrousgastroscopy,FG)检查及标本显示具有良好的对应性。CTVG在一定程度上具有显示慢性萎缩性胃炎、慢性糜烂性胃炎、慢性增殖性胃炎及急性出血性胃炎等细微病变结构的能力。当准直器宽度 3mm、螺距 1 2～ 1 5、重叠重建率 5 0 %～ 6 7%、呼吸控制良好、胃气量充足 ,以及采用适宜的扫描体位时可获得优质CTVG影像。结论 CTVG作为一种新兴的检查手段 。

Objective To investigate the values, methods and findings of computed tomographic virtual gastroscopy (CTVG). Methods Sixty nine patients underwent the examination of spiral CT after charged air into stomachs in different cubage. The CT scan conditions were collimating width 3 mm, pitch 1.2～2.5, scanning speed 0.8 s/360°, the raw data of CT volume scan was reconstructed in overlapping rate 33%～67%. Then the images of CTVG were built using navigator software (GE AG, USA). Results The accuracy, sensitivity ,and specificity of CTVG were 92.8%, 96.4%,and 78.6%, respectively. CTVG corresponded well with fibrous gastroscopy and specimens in demonstrating the gastric lesions. CTVG was provided with the ability of revealing the tiny lesions of chronic atrophic gastritis, chronic erosive gastritis, chronic proliferative gastritis, and acute hemorrhagic gastritis in some degree. The high quality imaging of CTVG could be obtained in condition of collimating width 3 mm, pitch 1.2～1.5, overlapping 50%～67%, well hold breath, gastric cubage in full and feasible scan positions. Conclusion CTVG is a rising means of gastric examination and has great value in clinic applications.