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结肠镜同CT增强对结肠癌定位准确性对比及错误定位影响因素分析 被引量:1
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作者 陆翠钦 颜丽君 何张平 《齐齐哈尔医学院学报》 2020年第5期549-552,共4页
目的对比结肠镜与CT增强在肠癌定位的准确性,分析可能导致内镜及CT定位错误的影响因素。方法选择2017年1月—2019年4月在本院肠镜检查发现结肠癌,并行手术且术前腹部增强CT检查的127例患者的临床资料进行回顾性分析,对比内镜及CT增强在... 目的对比结肠镜与CT增强在肠癌定位的准确性,分析可能导致内镜及CT定位错误的影响因素。方法选择2017年1月—2019年4月在本院肠镜检查发现结肠癌,并行手术且术前腹部增强CT检查的127例患者的临床资料进行回顾性分析,对比内镜及CT增强在结肠恶性肿瘤定位的错误率,并采用多因素Logistic回归分析,以找出影响内镜及CT定位错误的因素。结果内镜及CT定位错误率相似,分别为18.1%及13.4%,差异无统计学意义(P>0.05);多因素回归分析显示内镜检查不完整(OR=4.024,95%CI 2.987~5.062)及合并粘连(OR=3.304,95%CI 1.266~8.625)是内镜定位错误的危险因素;合并粘连(OR=5.152,95%CI 1.647~16.121)是CT定位错误的危险因素;肿瘤分期(OR=0.22,95%CI 0.064~0.76)是CT定位错误的保护性因素。结论内镜及CT增强均是结直肠癌定位的可靠依据,但均有一定的错误率;合并粘连增加内镜及CT对结肠癌的定位错误风险,不完整的内镜检查增加内镜定位错误的风险,晚期肿瘤(T3~T4)提高CT定位准确性,内镜医生及外科医生应注意对于可能存在粘连及内镜检查不完整的患者进一步采取其它措施提高定位准确性。 展开更多
关键词 结肠镜定位 CT定位 结直肠癌 危险因素
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术前内镜下自体血标记定位应用于腹腔镜结直肠肿瘤手术的临床效果分析 被引量:2
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作者 张海斌 张顺 +1 位作者 蒋小华 徐美东 《中华消化内镜杂志》 CSCD 2022年第11期925-927,共3页
为评价内镜下自体血标记定位在腹腔镜结直肠肿瘤术前应用的临床价值, 回顾分析2019年1月-2021年1月在同济大学附属东方医院行结肠镜下自体血定位并随后行腹腔镜手术的结直肠肿瘤患者资料30例。腹腔镜手术中根据结肠浆膜面局部红色标记... 为评价内镜下自体血标记定位在腹腔镜结直肠肿瘤术前应用的临床价值, 回顾分析2019年1月-2021年1月在同济大学附属东方医院行结肠镜下自体血定位并随后行腹腔镜手术的结直肠肿瘤患者资料30例。腹腔镜手术中根据结肠浆膜面局部红色标记判断病灶所在位置。术中探查评估染色清晰度, 观察有无注射自体血泄漏情况。所有患者在结肠镜下顺利完成自体血定位, 无出血、穿孔和发热等并发症。腹腔镜探查可见清晰的自体血染色部位, 未见染色弥散、泄漏污染术野情况。术后病理证实标本切缘阴性。说明经结肠镜下注射自体血是一种理想的腹腔镜结直肠肿瘤手术前病灶定位方法, 安全有效, 值得临床推广。 展开更多
关键词 结直肠肿瘤 腹腔镜手术 结肠镜定位 自体血
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Automatic anatomical classification of colonoscopic images using deep convolutional neural networks
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作者 Hiroaki Saito Tetsuya Tanimoto +7 位作者 Tsuyoshi Ozawa Soichiro Ishihara Mitsuhiro Fujishiro Satoki Shichijo Dai Hirasawa Tomoki Matsuda Yuma Endo Tomohiro Tada 《Gastroenterology Report》 SCIE EI 2021年第3期226-233,I0002,共9页
Background:A colonoscopy can detect colorectal diseases,including cancers,polyps,and inflammatory bowel diseases.A computer-aided diagnosis(CAD)system using deep convolutional neural networks(CNNs)that can recognize a... Background:A colonoscopy can detect colorectal diseases,including cancers,polyps,and inflammatory bowel diseases.A computer-aided diagnosis(CAD)system using deep convolutional neural networks(CNNs)that can recognize anatomical locations during a colonoscopy could efficiently assist practitioners.We aimed to construct a CAD system using a CNN to distinguish colorectal images from parts of the cecum,ascending colon,transverse colon,descending colon,sigmoid colon,and rectum.Method:We constructed a CNN by training of 9,995 colonoscopy images and tested its performance by 5,121 independent colonoscopy images that were categorized according to seven anatomical locations:the terminal ileum,the cecum,ascending colon to transverse colon,descending colon to sigmoid colon,the rectum,the anus,and indistinguishable parts.We examined images taken during total colonoscopy performed between January 2017 and November 2017 at a single center.We evaluated the concordance between the diagnosis by endoscopists and those by the CNN.The main outcomes of the study were the sensitivity and specificity of the CNN for the anatomical categorization of colonoscopy images.Results:The constructed CNN recognized anatomical locations of colonoscopy images with the following areas under the curves:0.979 for the terminal ileum;0.940 for the cecum;0.875 for ascending colon to transverse colon;0.846 for descending colon to sigmoid colon;0.835 for the rectum;and 0.992 for the anus.During the test process,the CNN system correctly recognized 66.6%of images.Conclusion:We constructed the new CNN system with clinically relevant performance for recognizing anatomical locations of colonoscopy images,which is the first step in constructing a CAD system that will support us during colonoscopy and provide an assurance of the quality of the colonoscopy procedure. 展开更多
关键词 COLONOSCOPY deep learning ENDOSCOPY neural network
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