多层螺旋CT仿真肠镜与结肠镜检查技术在发现结肠肿瘤的应用价值对比

The Application Value Between Multislice Spiral CT Virtual Endoscopy and Colonoscopy Technology Application in Colon Tumors

目的探讨多层螺旋CT三维重建与仿真肠镜在结肠肿瘤病变诊断中的应用价值并对比结肠镜检查结果。方法对我院2009年1月至2014年1月来我院就诊的疑似结肠占位的患者应用SIEME 64层螺旋CT对200例例患者行一次屏气全结肠容积扫描,并利用工作站进行后处理以获取CT仿真肠镜(CTVC),多平面重建(MPR),表面阴影成像(SSD)和透明显示(Ray sum)图像,并结合原始横断面等图像进行分析,再行结肠镜检查对照。结果与结肠镜相比,CTVC诊断阳性率较结肠镜高,CTVC检出26例结肠镜检查为正常的患者,12例误诊为结肠息肉,检出结直肠癌200例,敏感度为100%,特异度94%。结论多层螺旋CT三维重建及仿真内镜是一种无创伤性的影像学检查方法,对结直肠占位病变的诊断有其独特的优越性尤其是结肠癌诊断的敏感度、特异度及准确度均较高,可作为纤维结肠镜有价值的补充检查手段,能弥补结肠镜检查中的不足,给临床诊断带来巨大前景。

Objective To investigate the three-dimensional reconstruction and virtual endoscopy of multi-slice spiral CT in the diagnosis of colon tumor lesions and compared with colonoscopy findings. Methods From 2009 January to 2014 January in our hospital suspected colonic lesions were treated with SIEME 64 slice spiral CT in 200 cases of patients underwent volume scanning using colon, and after-treatment technology of CT workstation was used to obtain simulated colonoscopy （CTVC）, multi planar reconstruction （MPR）, surface shading imaging （SSD） and the transparent display （Ray sum） image, and combined with the original cross-sectional images were analyzed, and then underwent colonoscopy control. Results compared with colonoscopy, the positive rate of CTVC had higher positive rate. CTVC detected 26 cases of colonoscopy in normal patients, 12 cases were misdiagnosed as colon polyps, colorectal cancer was detected in 200 cases, the sensitivity is 100%. Conclusion multi slice spiral CT three-dimensional reconstruction and virtual endoscopy is a noninvasive imaging method, the diagnosis of space occupying lesion of the colon has its unique superiority especially colorectal cancer diagnosis sensitivity, specificity and accuracy were higher, supplementary examination can be used as fiber colonoscopy valuable, can to make up for lack of colonoscopy in the diagnosis, to bring tremendous prospects.