MSCT充气造影检查对食管疾病的诊断价值

Application of air contrast multi-slice CT in the diagnosis of esophageal diseases

目的探讨多层螺旋CT(MSCT)充气造影检查对食管疾病的诊断价值。方法选择100例经胃镜及手术病理证实的食管疾病患者,均行MSCT充气造影检查,将扫描后的图像进行薄层重建及后处理,对MSCT充气造影结果与病理结果进行比较,并采用Kappa检验分析其一致性。结果 100例食管疾病患者中,经消化胃镜及术后病理证实,食管平滑肌瘤62例,食管癌8例,食管憩室6例,食管囊肿8例,隆突下增大淋巴结结核2例,食管血管瘤4例,正常食管10例。所有患者均顺利完成MSCT充气造影检查,食管管腔扩张良好。经Kappa检验,MSCT充气造影结果与病理结果具有良好的一致性(Kappa值=0.898,P﹤0.001)。MSCT充气造影诊断食管平滑肌瘤的特异度、灵敏度和准确率分别为96.8%、78.9%、90.0%,诊断食管癌的特异度、灵敏度和准确率均为100%。结论 MSCT充气造影检查作为一种诊断食管疾病的新方法,有利于提高食管疾病的检出率,在临床中具有重要的应用价值。

Objective To investigate the diagnostic value of air contrast multi-slice computed tomography （ACCT） in the diagnosis of esophageal diseases. Method 100 patients with endoscopically and pathologically confirmed esopha-geal diseases were examined by ACCT （using air as the contrast agent in computed tomography scans）, multiplanar recon-struction was performed to compare the ACCT and pathological results, while Kappa test was adopted to evaluate the con-sistency. Result In the 100 patients with esophageal diseases that were confirmed endoscopically and pathologically, there were 62 cases of esophageal leiomyoma, 8 cases of esophageal cancer, 6 cases of esophageal diverticulum, 8 cases of esophageal cyst, 2 cases of lymphatic tuberculosis, 4 cases of esophageal hemangioma, and 10 cases of normal esopha-gus. All patients had competed ACCT tests, with well distended esophagus. The Kappa consistency analysis showed rea-sonable consistency between ACCT and pathological diagnosis （Kappa=0.898, P〈0.001）. The specificity, sensitivity and precision of ACCT in diagnosing esophageal leiomyoma were 96.8%, 78.9%, and 90.0%;And were all 100%in detecting esophageal cancer. Conclusion ACCT, which is a new technique, is valuable in improving the diagnosis of esophageal diseases, with promising clinical importance.