气钡双重造影与CT仿真内镜技术对结直肠肿瘤诊断价值的前瞻性研究

Prospective study of double-contrast barium enema and CT colonography in diagnostic value of colonrectal neoplasm

目的：通过气钡双重造影（ double-contrast barium enema,DCBE）与CT仿真内镜（ CT colonography, CTC）在结直肠肿瘤的检出效能比较,明确两种检查方法的作用。方法2008年1月至2013年12月共计入组患者648例,均在同1天先后完成CTC和DCBE检查并记录每个检出病灶的大小和部位。以结肠镜及手术作为金标准,对两组数据进行比较分析。结果所有患者中共检出1180处病灶,CTC和DCBE分别检出1127处和942处病灶,两组检出率差异均有显著性。其中〈0.5cm、0.5cm ~〈1cm、1cm ~〈2cm、2cm ~〈3cm、≧3cm的病灶数分别检出为53处、151处、152处、71处、753处。 CTC与DCBE对〈0.5cm、0.5cm~〈1cm、1cm~〈2cm、2cm~〈3cm、≧3cm的病灶检出率分别为61.2%、84.2%、93.4%、100.0%、100.0%和9.4%、30.9%、47.0%、93.0%、100.0%。对于〈2cm的病灶,CTC检出率明显优于DCBE,而对≧2cm病灶检出方面,两种检查方法没有差别。结论在结直肠肿瘤检查效能方面,CTC明显优于DCBE,尤其是对〈2cm的病灶,CTC检查更具优势。

Objective Comparared with the detection efficiency of colorectal cancer by double-contrast barium enema and CT colonography to clear and definite the role of two inspection method. Method 648 cases of patients were in-cluded from 2008 January to 2013 December;CTC and DCBE examination had been completed and each detected lesion size and location was record in the same day. With colonoscopy and operation as the gold standard, the two sets of data had been carried on comparative and analysis. Result 1180 lesions were detected in all patients. 1127 and 942 lesions were detected with CTC and DCBE respectively, there was significant difference between the two ex-aminations. 〈0. 5cm,0. 5cm~〈1cm,1cm~〈2cm,2cm~〈3cm and≧3cm lesions were 53,151,152,71 and 753 respectively. The sensitivity of CTC and DCBE for 〈0. 5cm,0. 5cm~〈1cm,1cm~〈2cm,2cm~〈3cm and≧3cm were 61. 2%,84. 2%,93. 4%,100%,100% and 9. 4%,30. 9%,47%,93%,100% respectively. There was sig-nificant difference between the two examinations for the lesions smaller than 2cm, but no difference for the larger. Conclusion CTC is obviously better than DCBE for detecting colorectal neoplasm, especially for 〈2cm lesions.