结直肠疾病部分合并便秘患者疾病低剂量多层螺旋CT结肠成像的应用及其临床意义研究

Application and Clinical Significance of Low Dose Multi-slice CT Colon Imaging in Patients with Colorectal Diseases and Constipation

目的探讨分析结直肠疾病部分合并便秘患者疾病中低剂量多层螺旋CT结肠成像的应用及其临床意义研究。方法选取2015年1月至2018年1月期间我院收治的结直肠疾病部分合并便秘患者160例,行中、低剂量多层螺旋CT结肠成像和多重面重建,并与常规剂量多层螺旋CT、气钡双对比造影、电子肠镜或手术病理结果进行对比,观察并记录应用低剂量MSCT对于结直肠疾病的定性、定位的准确率及成像质量。结果通过电子肠镜及手术病理,160例患者中定性诊断结直肠癌、结肠息肉、多发性憩室、痔疮、结直肠炎症患病例数分别为65(40.625%)、38(23.750%)、26(16.250%)、7(4.375%)、24(15.000%),定位诊断乙状结肠、直肠、升结肠、盲肠患病例数分别为46(28.750%)、89(55.625%)、17(10.625%)、8(5.000%)。低剂量MSCT定性诊断结果的敏感性、特异性分别为87.474%、86.357%,定位诊断结果的敏感性、特异性分别为96.356%、95.382%,与电子肠镜以及手术病理结果比较差异无统计学意义(P>0.05)。常规剂量MSCT及低剂量MSCT,影像学评分差异无统计学意义(P>0.05),低剂量MSCT的影像学评分明显高于气钡双对比造影,差异有统计学意义(P<0.05)。结论低剂量多层螺旋CT结肠成像应用于结直肠疾病部分合并便秘患者,可有效定位和定性诊断疾病,多重面重建后成像质量高。

Objective To investigate the application and clinical significance of low-dose multi-slice spiral CT colonography in the diagnosis of patients with constipation caused by colorectal disease.Methods A total of 180 patients with constipation who underwent surgery in our hospital from January to February 2018 underwent low-dose multi-slice spiral CT colonography and multiplesided reconstruction,with more conventional doses.The results of layer spiral CT,double contrast angiography,electron colonoscopy and surgical pathology were compared to observe the qualitative,accurate and imaging quality of MSCT for colorectal diseases.Results Through electronic colonoscopy and surgical pathology,the number of cases of colorectal cancer,colon polyps,multiple diverticulum,acne,and colorectal inflammation in 160 patients were 65(40.625%)and 38(23.750%,respectively).),26(16.250%),7(4.375%),24(15.000%),the number of cases diagnosed with sigmoid colon,rectum,ascending colon,and cecum were 46(28.750%),89(55.625%),17(10.625%),8(5.000%).The sensitivity and specificity of the qualitative diagnosis of low-dose MSCT were 87.474%and 86.357%,respectively.The sensitivity and specificity of the localization diagnosis were 96.356%and 95.382%,respectively.There was no statistical difference between the results of electronic colonoscopy and surgical pathology.Academic significance(P>0.05).There were no significant differences in imaging scores between conventional doses of MSCT and low-dose MSCT(P>0.05).The imaging scores of medium-and low-dose MSCT were significantly higher than those of gas-filled double contrast angiography(P<0.05).Conclusion Low-dose multi-slice spiral CT colonography is applied to patients with constipation complicated with colorectal disease,which can effectively locate and qualitatively diagnose diseases.The imaging quality after multi-face reconstruction is high.