多模态MR与CT小肠造影诊断小肠肿瘤性疾病的对比观察

Small bowel tumor:a comparative study of multi-modality MR enterography and CT enterography as diagnostic technique

目的:比较多模态MR小肠口服造影法与CT小肠造影在诊断小肠肿瘤性疾病中的价值。方法:对本院2012年2月至2014年8月对怀疑有小肠肿瘤的65例患者行CT和多模态MR小肠造影检查。由两位腹部影像学医师分别对CT及MR图像进行分析,记录十二指肠、近段空肠、远段空肠、近段回肠以及远段回肠肠管的病变累及情况,并与手术以及内镜活检病理结果进行对照。结果:经手术及内镜病理证实,65例中共37例患者有38个小肠肿瘤病灶(腺癌6例,淋巴瘤7例,间质瘤18例,神经内分泌肿瘤3例,海绵状血管瘤2例,脂肪瘤2例)。CT及MRI对小肠肿瘤性病变的检出率分别为97.4%(37/38)和94.7%(36/38);McNemar检验结果显示,CT小肠显像与多模态小肠MR口服造影法对于多部位侵犯的小肠肿瘤性病变的诊断敏感度和特异度的差异无统计学意义(P>0.05)。两例黏膜海绵状血管瘤伴出血仅在CT图像上显示。结论:多模态MR小肠口服造影法与CT小肠造影均是诊断小肠肿瘤性疾病的有效手段。

Objective：To compare the diagnostic value of multi-modality MR enterography and CT enterography in small bowel tumor.Methods：From February 2012 to August 2014,Sixty-five patients who were suspected with small bowel diseases underwent CT enterography and multi-modality MR enterography.Two independent readers evaluated CT and MR images for presence of small bowel lesions in duodenum,proximal jejunum,distal jejunum,proximal ileum and distal ileum which were pathologically confirmed by operation and endoscopic biopsy.Results：Of 65 cases,38small bowel tumors in 37 patients were confirmed（6adenocarcinomas,7lymphomas,18 gastrointestinal stromal tumors,3neuroendocrine tumors,2hemangiomas,2lipomas）.The detection rate of multi-modality MR enterography and CT enterography in diagnosing small bowel tumor was 97.4%（37/38）and 94.7%（36/38）respectively,with no significant difference（P〈0.05）.The results of statistic analysis（McNemar test）showed that there was no significant difference of specificity and sensitivity between multi-modality MR enterography and CT enterography for evaluating the tumor diseases located at different segments of small bowel（P〈0.05）.Conclusion：Multi-modality MR enterography and CT enterography are useful methods for diagnosing small bowel tumors.