多层(四层)螺旋CT结肠仿真内窥镜的临床应用  

Clinical Application of Multi-slice helical CT Virtual Colonoscopy

作　　者：许有生[1] 沈纪林[1] 黄小荣[2] 杨其根[1] 邬万新[3] 余强[1] 王土兴[1] 吴金兴[1] 

机构地区：[1]浙江省嘉兴市第一医院,嘉兴学院医学院附属第一医院放射科,3140001 [2]浙江省嘉兴市第一医院,嘉兴学院医学院附属第一医院消化科内窥镜室,3140001 [3]浙江省嘉兴市第一医院,嘉兴学院医学院附属第一医院病理科,3140001

出　　处：《现代医用影像学》2004年第5期213-218,共6页Modern Medical Imageology

基　　金：中华医学基金会 2 0 0 2年"中国多层螺旋CT研究基金"赞助项目;浙江省嘉兴市科委立项科研课题

摘　　要：目的 :研究多层螺旋CT仿真结肠镜 (MSCTVC)检查的临床应用价值。材料与方法 :应用MSCTVC和电子结肠镜 (EC)对 30例病人进行检查对照。其中 17例还作了病理学检查。结果 :MSCTVC与EC诊断符合 ,结肠癌 15例 ,息肉 9例(其中 1例息肉直径 6mm) ,囊肿 1例。MSCTVC与EC不符合 5例 ,其中 1例EC未插入升结肠 ,MSCTVC发现升结肠癌 ;1例EC发现多发性息肉 ,MSCTVC发现结肠癌 ;1例EC发现乙状结肠息肉 ,MSCTVC加SSD发现横结肠冗长 ;1例EC插不进 ,MSCTVC发现回盲部癌 ;1例EC发现左半结肠 1个息肉 ,右半结肠插不进 ,MSCTVC发现升结肠、肝曲、脾曲各有 1个息肉。17例作病理学检查 ,MSCTVC和EC诊断为结肠癌者病理诊断为腺癌 9例 ,良恶性不能明确者 2例 ,MSCTVC和EC诊断为息肉者 ,病理学诊断为腺瘤 5例 ,慢性炎症 1例。 30例中 ,3例EC诊断为结肠炎症 ,MSCTVC诊断为正常。 4例EC失败 ,MSCTVC完成检查 ,诊断正常。结论 :MSCTVC对结肠隆起性病变是一种有效的检查方法。Purpose:To evaluate multi-slice helical CT virtual colonoscopy (MSCTVC) in the clinical practive.Materials and Methods:MSCTVC was performed in 30 patients with colonic disease.Of 30 cases,30 cases were proved by electronic colonoscope (EC) and 17 cases by biopsy.Results:MSCTVC and EC had a diagnosis coincidence in 15 cases of colonic cancer and 9 cases of polyps (One of the polyps only has a diameter of 6 mm) and one case of cyst.MSCTVC and EC had no diagnosis coincidence in 5 cases,one of them failed to reach ascending colon endoscopically which was diagnosed of ascending colon cancer by MSCTVC.From another one who fail to reach ascending colon endoscopically,only multiple polyps were diagnosed by EC,a colon cancer was detected by MSCTVC.One case suffered from a sigmoid polyp confirmed by EC,was diagnosed a lengthy colon;One case failed by EC was diagnosed cecum cancer by MSCTVC.One case was only found a polyp in left colon,failed to reach right colon by EC,was detected multiple polyps in the right colon by MSCTVC.Seventeen cases diagnosed colon cancer by both MSCTVC and EC took pathological examinations.Nine cases of them were adenocarcinoma.Two of them could not be confirmed (whether benign or malignant).Five of polyps dignosed by both MSCTVC and EC were detected adenoma by pathological examination.One of them has chronic inflammation.In addition,3 cases diagnosed colon inflammation by EC were diagnosed normal by MSCTVC.MSCTVC could not find inflammation.Four cases failed by EC,were found normal by MSCTVC.Conclusion:MSCTVC is a new means of colonic examination and has high value of clinical application.

关 键 词：多层螺旋CT 结肠疾病 仿真内窥镜 临床应用 

分 类 号：R816.5[医药卫生—放射医学]