CT对胃肠道疾病的诊断价值

Comparison imagiology of X-Ray,CT,MRI and DSA diagnosing gastroenteropathy

目的：比较X线、CT、MRI及DSA在胃肠病变检诊中的应用价值。方法2012年1月～2012年12月间在我科进行影像学检查的胃肠病变患者纳入研究对象，共94例，其中男52例，年龄2～81岁，中位年龄52岁；女42例，年龄8～87岁，中位年龄59岁。检查方法包括 X 线消化道气钡双重造影，CT 平扫，CT 增强（CT-CE），CT 血管造影（CTA），MRI平扫，MRI增强，数字血管减影血管成像（DSA）。在随访中，以消化内镜检查和（或）手术病理诊断为参考标准，评价影像方法的诊断正确率。结果94例患者中，X线消化道气钡双重造影检查14例，明确诊断12例，另2例通过C T检查明确诊断。C T检查68例，平扫明确诊断7例，进一步增强扫描明确诊断57例，再进一步结合消化道气钡双重造影明确者1例、MRI明确者1例、DSA明确者1例，还有1例通过手术探查明确。CTA检查11例，直接明确诊断者8例，进一步DSA明确者3例。MRI检查1例，未能直接明确诊断，进一步CT检查明确。结论 CT在胃肠病检诊中较X线、M RI和DSA具有更高的诊断价值，但是合理联合多种方法能够弥补单一影像学方法显示病变的局限，可以明显提高对胃肠病变的诊断正确率。

Objective To compare the diagnostic ability of X-ray ,CT ,MRI and DSA in gastroenteropathy .Methods 94 cases with gastroenteropathies were included in this study who had been diagnosed by radiology from Jan 2012 to Dec 2012 .In these cases ,males were 52 aged from 2~81 years with median age 52 years ,and females were 42 aged from 8--87 years with median age 59 years .Radiology examination methods were X-ray air-Ba double contrast radiography ,CT plain scan ,CT contrast enchancement （CT-CE） scan ,CT angiography （CTA） ,MRI and digital substraction angiography （DSA） .Took digestive endoscopy examination and （or） operation-pathological diagnosis obtained by following-up as the reference standard to evaluate the diagnostical capability of imaging methods in gastroenteropathy .Results In 94 cases , 14 received X-ray air-Ba double contrast radiography ,among them ,12 directly got identify diagnosis ,the other 2 got iden-tify diagnosis by CT in further examination ;68 received CT ,among them ,7 directly got identify diagnosis by CT plain scan ,in further examination performed for identify diagnosis ,57 by CT-CE ,and in next further examination ,1 by X-ray air-Ba double contrast radiography ,1 by MRI ,1 by DSA and 1 by operation research ;11 received CTA ,among them ,8 directly got identify diagnosis and 3 by DSA in further examination .Only 1 case received MRI but got no identify diagno-sis ,further CT examination help to get diagnosis .Conclusion CT relatively has higher diagnostic value compraring with X-ray ,M RI and DSA in gastroenteropathy ,but combination of multiple imaging methods could make up the limitation of single method ,significantly improving the diagnostic capability in gastroenteropathy .