256层螺旋CT低张造影技术在小肠病变中的应用价值

Application value of 256 slice spiral CT and hypotonic angiography in small intestine diseases

目的探讨256层螺旋CT低张造影技术在小肠疾病诊断中的应用价值。方法收治的47例疑似小肠疾病的患者为研究对象,所有患者均采取口服甘露醇并注射山莨菪碱后进行多层螺旋CT小肠低张造影技术扫描检查,并实施动态监测双期增强扫描,采集的数据进行最大密度投影(MIP)、多平面重建(MRP)、容积重建技术(VRT)等后处理技术进行处理,诊断医师根据对图像显示情况进行分析得出能够用于诊断的显示最佳的0级率图像,同时与临床内镜或病理结果相对照,从而得出多层螺旋CT造影技术(MSCTE)在小肠病变诊断的阳性率。结果 MSCTE检查对小肠黏膜与肠壁结构、系膜血管、肠管充盈等显示良好,显示0级率分别为70. 21%(33/47)、89. 36%(42/47)和74. 47%(35/47)。47例中小肠癌15例,Crohn氏病5例,淋巴瘤1例,间质瘤3例,血管瘤1例,炎症5例,憩室4例,不完全性梗阻2例,肠系膜血管动脉瘤伴血栓5例,腹主动脉瘤2例,阴性2例,肠道准备不充分1例,漏诊1例,诊断的阳性率为91. 5%。结论MSCTE技术应用于小肠疾病诊断中具有较高价值,为临床制定有效治疗方案提供参考。

Objective To evaluate the application value of 256 slice spiral CT and hypotonic angiography in small intestine diseases. Methods 47 patients with suspected small intestine diseases were included in this study,All patients were orally given mannitol and injected with anisodamine,and underwent multi-slice spiral CT scan of hypotonic angiography in small intestine,the dynamic monitoring and dual phase enhanced scanning were also performed,the acquired data were processed by post-processing techniques such as maximum density projection（MIP）,multiplanar reconstruction（MRP） and volume reconstruction（VRT）.According to the analysis of the image display,the diagnostic doctor showed the best 0 rate image that can be used for diagnosis.Meanwhile,the results were compared with those of clinical endoscopy or pathology,the positive rate of multi-slice helical CT angiography（MSCTE） in the diagnosis of small intestine lesions was obtained. Results The MSCTE examination showed a good view of the small intestinal mucosa and the intestinal wall,the mesentery vessels,and the filling of the intestine. The grade 0 rates were 70. 21%（33/47）,89. 36%（42/47） and 74. 47%（35/47）. The were 47 cases of 15 cases of small intestinal carcinoma,5 cases of Crohn＇s disease,1 case of lymphoma,3 cases of stromal tumors,1 case of hemangioma,5 cases of inflammation,4 cases of diverticulum,2 cases of incomplete obstruction,5 cases of mesenteric artery aneurysm with thrombosis,2 cases of abdominal aortic aneurysms. 2 cases were negative,1 case was inadequate of the bowel preparation,and 1 case was missed diagnosis. The positive rate of diagnosis was 91. 5%. Conclusion MSCTE technique is very valuable to the diagnosis of small intestine diseases,the anatomical structure of the small intestine can be clearly shown and it is beneficial to clinical preoperative staging,so as to formulate treatment plan and prognosis evaluation.