小肠CTE在炎性肠病及小肠肿瘤早期病变诊断中的应用价值讨论

Discussion on the application value of CTE in the diagnosis of inflammatory bowel disease and early lesions of small bowel tumors

目的研究小肠CT造影(CTE)在炎性肠病及小肠肿瘤早期病变诊断中的作用。方法回顾性分析122例疑似炎性肠病和小肠肿瘤早期病变患者的临床资料,所有患者均进行小肠CTE检查,并获取病理组织。以病理诊断作为金标准,对比小肠CTE与病理诊断对炎性肠病和小肠肿瘤早期病变的检出率,分析小肠CTE对炎性肠病和小肠肿瘤早期病变的诊断效能。结果病理检出炎性肠病89例,小肠肿瘤早期病变27例,十二指肠溃疡3例,肠息肉3例;小肠CTE检出炎性肠病86例,小肠肿瘤早期病变25例。小肠CTE对炎性肠病和小肠肿瘤早期病变的检出率与病理诊断对比,差异无统计学意义(P>0.05)。小肠CTE诊断炎性肠病的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为97.67%、86.11%、94.38%、93.94%、94.26%、0.8832、6.06%、5.62%;小肠CTE诊断小肠肿瘤早期病变的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为96.00%、96.91%、88.89%、98.95%、96.72%、0.8784、1.05%、11.11%。结论通过小肠CTE对炎性肠病和小肠肿瘤早期病变进行诊断能够发挥良好的诊断作用,可以为临床诊断和治疗提供科学的参考。

Objective To study the role of CT enterography(CTE)in the diagnosis of inflammatory bowel disease and early lesions of small bowel tumors.Methods The clinical data of 122 patients with suspected inflammatory bowel disease and small bowel tumors were retrospectively analyzed,and all patients underwent CTE,and pathological tissues were obtained.The pathological diagnosis was used as the standard to compare the detection rate of CTE and pathology for the diagnosis of inflammatory bowel disease and early lesions of small intestine tumor,and the diagnostic efficiency of CTE for the diagnosis of inflammatory bowel disease and early lesions of small intestine tumor was analyzed.Results Pathology detected 89 cases of inflammatory bowel disease,27 cases of early lesions of small intestinal tumors,3 cases of duodenal ulcers,and 3 cases of intestinal polyps.CTE detected 86 cases of inflammatory bowel disease and 25 cases of early lesions of small intestinal tumors.There was no statistically significant difference in the detection rate of inflammatory bowel disease and early lesions of small intestinal tumor by CTE and pathology(P>0.05).The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden's index,misdiagnosis rate and missed diagnosis rate of CTE in the diagnosis of inflammatory bowel disease were 97.67%,86.11%,94.38%,93.94%,94.26%,0.8832,6.06%and 5.62%,respectively.The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden's index,misdiagnosis rate and missed diagnosis rate of CTE in the diagnosis of early lesions of small intestinal tumors were 96.00%,96.91%,88.89%,98.95%,96.72%,0.8784,1.05%and 11.11%,respectively.Conclusion The diagnosis of inflammatory bowel disease and early lesions of small bowel tumor through CTE can play a good diagnostic role,and can provide a scientific reference for clinical diagnosis and treatment.