CT仿真结肠镜与腹部增强CT在炎症性肠病诊断中的对比分析

Comparative Analysis of CT Virtual Colonoscopy and Enhanced Abdominal CT in the Diagnosis of Inflammatory Bowel Disease

目的:对比CT仿真结肠镜(CTC)与腹部增强CT在炎症性肠病诊断中的价值,为临床诊疗提供依据。方法:选取2015年1月到2016年1月我院收治的炎症性肠病患者60例为研究组,另选取非炎症性肠病患者60例为对照组,两组均30例患者接受CTC检查,30例患者接受腹部增强CT检查,对影像图片进行盲法阅读,将炎症性肠病的可信度分为5个等级进行评价,对6项影像学特征进行Logistic回归分析。结果:腹部增强CT对炎症性肠病诊断的准确率、敏感性、特异性分别为68.33%,59.09%,71.39%显著低于CTC的93.33%,95.01%、89.63%,比较差异具有统计学意义(P<0.05);Logistic回归分析显示:结肠粘膜呈颗粒状、不光滑;肠壁强化并增厚;结肠袋消失对炎症性肠病具有预测作用;肠壁强化及增厚对炎症性肠病诊断敏感性较高,结肠粘膜呈颗粒状、不光滑联合结肠袋消失诊断炎症性肠病的特异性较高。结论:CTC对炎症性肠病具有较高的检出率,肠壁强化及增厚对炎症性肠病诊断的敏感性较高,结肠粘膜呈颗粒状、不光滑联合结肠袋消失诊断炎症性肠病特异性较高。

Objective： To compare the value of CT virtual colonoscopy （CTC） and enhanced CT in the diagnosis of inflammatory bowel disease, to provide the basis for clinical diagnosis and treatment. Methods： 60 cases of inflammatory bowel disease who treated in our hospital from January 2015 to January 2016 were selected as the study group, another 60 cases of non inflammatory bowel disease were selected as the control group,two groups of 30 patients undergoing CTC examination,30 patients underwent abdominal CT examination, the images were blinded reading, the credibility of inflammatory bowel disease was divided into 5 grades for evaluating,6 kinds of imaging features was Logistic regression analyzed. Results： The accuracy, sensitivity and specificity of abdominal enhancement CT in diagnosis of inflammatory bowel disease were 68.33%, 59.09%,71.39%, significantly lower than 93.33%, 95.01%, 89.63% of CTC, the difference was statistically significant （P 〈 0.05）; Logistic regression analysis showed that：the colonic mucosa was granular and smooth; and enhancement of intestinal wall thickening; colonic pouch disappeared have prediction effect on inflammatory bowel disease; the intestinal wall thickening and enhancement of sensitivity on the diagnosis of inflammatory bowel disease, the colonic mucosa was not smooth, high specificity granular colon bag disappeared in diagnosis of inflammatory bowel disease. Conclusion： CTC has a higher detection rate of inflammatory bowel disease, the intestinal wall thickening and enhancement had higher sensitivity in diagnosis of inflammatory bowel disease, the colonic mucosa was granular and smooth colon bag disappeared had higher specificity in diagnosis of inflammatory bowel disease.