单气囊小肠镜及小肠CT造影诊断小肠间质瘤的价值对比

The diagnostic value of different examination methods for small intestinal stromal tumor

目的 探讨单气囊小肠镜及小肠CT造影(CTE)对诊断小肠间质瘤的部位及大小的准确性,分析术后病理危险度与临床指标的相关性。方法 回顾性分析2017年1月~2020年10月在陆军军医大学第二附属医院行单气囊小肠镜及CTE,发现小肠占位,同时病理诊断证实为小肠间质瘤的患者共21例。比较小肠镜及CTE与术中对肿瘤部位及大小的诊断准确程度,分析病理危险度与临床表现及年龄、性别等的相关性。结果 21例患者符合纳入标准,其中便血16例(76.2%),腹痛5例(23.8%)。年龄23~78岁,平均(53±15.31)岁,小肠间质瘤多位于空肠上段,小肠镜、CTE对肿瘤大小的测定与术中测定大小之间差异均有统计学意义(P<0.05),但CTE对肿瘤大小的诊断优于小肠镜。单因素分析,病理危险程度与年龄、血红蛋白、症状相关性有统计学意义(均P<0.05)。结论 小肠间质瘤好发于空肠上段;辅助检查小肠镜、CTE对肿瘤大小的测定比真实测量值偏小,与小肠镜相比较,CTE更接近真实测量值;病理风险度与年龄、临床症状及出血程度有关。

Objective To compare the accuracy of different auxiliary examinations in the diagnosis of intestinal stromal tumor site and size,and analyze the correlation between postoperative pathological risk and clinical indicators.Methods A retrospective analysis was performed on 21 cases of small intestinal stromal tumor diagnosed by pathology after single balloon colonoscopy and CTE in the Second Affiliated Hospital of The Army Military Medical University between January,2017 and October,2020.The accuracy of intraoperative diagnosis of tumor site and size was compared with colonoscopy and CTE,and the correlation between pathological risk and clinical manifestations,age and gender was analyzed.Results Twenty-one patients met the inclusion criteria,including 16 cases of hematochezia(76.2%)and 5 cases of abdominal pain(23.8%).Their age was 23~78 years,with average age of(53±15.31)years,most of the small intestinal stromal tumors were located in the upper jejunum.There was statistical significance between the tumor size measured by colonoscopy and CTE and the intraoperative size(P<0.05),but CTE was superior to colonoscopy in the diagnosis of tumor size.Univariate analysis showed that pathological risk degree was significantly correlated with age,hemoglobin,symptoms(P<0.05).Conclusion Small intestinal stromal tumors are most common in the upper jejunum.In the auxiliary examination of CTE,the tumor size measured by colonoscopy was smaller than the true value,and CTE was closer to the true value compared with colonoscopy.Pathological risk is related to age,clinical symptoms,and bleeding degree.