CT在结肠息肉EMR术前、术后病情评估的临床应用

Clinical Application of CT in the Evaluation of Colonic Polyps Before and After EMR

目的探讨CT在结肠息肉EMR术前、术后病情评估的临床应用。方法选取2018年1月至2020年1月收入我院消化内科经EMR治疗的结肠息肉患者100例为研究对象,对患者进行CT检查及病理检查,以病理检查为“金标准”。观察患者的CT诊断结果、息肉大小及发病部位、术后复发率及临床价值。结果100例患者中,病理检查发现息肉159枚,CT检查检测119枚,检出率为74.84%。CT检测119枚息肉中,位于升结肠12枚、横结肠16枚、降结肠24枚、乙状结肠67枚;息肉直径<0.5cm24枚,0.6~1.5cm37枚,1.6~2.4cm58枚。术后6个月对患者进行复查,病理检查共发现结肠息肉22枚,CT复检出息肉20枚,检测率为90.91%。CT检查结肠息肉的灵敏度95.0%、特异度97.8%、阳性预测值86.4%、阴性预测值99.3%、准确率97.5%。结论CT检查在结肠息肉中具有一定的诊断价值,且对于EMR术后息肉的复发准确率较高。

Objective To explore the clinical application of CT in the evaluation of colon polyps before and after EMR.Methods A total of 100 patients with colonic polyps who were admitted to the Department of Gastroenterology of our hospital and received EMR treatment from January 2018 to January 2020 were selected for CT and pathological examinations with pathological examination as the gold standard.The patient's CT diagnosis results,polyp size and lesion location,postoperative recurrence rate and clinical value were observed.Results Among 100 patients,159 polyps were found by pathological examination and 119 were detected by CT examination withthe detection rate of 74.84%.Among the 119 polyps by CT,12 were in the ascending colon,16 in the transverse colon,24 in the descending colon,and 67 in the sigmoid colon.The diameter of polyps was<0.5 cm(24 cases),0.6 to 1.5 cm(37 cases),and 1.6 to 2.4 cm(58 cases).The patient was re-examined 6 months after the operation.A total of 22 colonic polyps were found in pathological examination and 20 polyps were re-examined by CT with the detection rate of 90.91%.CT examination of colon polyps had a sensitivity of 95.0%,a specificity of 97.8%,a positive predictive value of 86.4%,a negative predictive value of 99.3%,and an accuracy rate of 97.5%.Conclusion CT examination has a certain diagnostic value in colon polyps,and the accuracy rate is high in polyp’s recurrence after EMR.