多层螺旋CT结肠水灌肠与钡剂灌肠及纤维结肠镜对大肠病变诊断价值  

Multislice CT water enema versus colonoscopy and contrast barium enema for evaluation of large bowel diseases

作　　者：赵锡海[1] 许建荣[1] 李澄[2] 华佳[1] 路青[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,上海200001 [2]江苏省扬州市第一人民医院影像科,江苏扬州225001

出　　处：《中国医学影像技术》2006年第6期923-926,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的通过比较MSCT结肠水灌肠、钡剂灌肠(BE)及纤维结肠镜对大肠病变诊断的准确率,探讨三者检查方法在大肠病变诊断方面的优缺点。方法对43例怀疑大肠病变的患者行MSCT结肠水灌肠检查,其中21例先后接受BE检查,22例先后接受结肠镜检查。比较三种检查方法对大肠评价范围全面性、大肠病变的定位、定性诊断准确性有无差异。结果MSCT结肠水灌肠、BE、肠镜对大肠评价范围全面性百分率分别为90.70%、95.24%、50%,MSCT与BE比较无显著差异,与肠镜比较有显著差异。MSCT结肠水灌肠、BE、肠镜对大肠病变定位/定性的准确率分别为86.05%/86.05%、76.19%/66.67%、59.09%/77.27%,MSCT结肠水灌肠对大肠病变定位准确率高于肠镜,与BE比较无显著差异。三种检查方法对大肠病变定性诊断的准确率均无显著差异。结论MSCT结肠水灌肠对大肠评价范围全面,对大肠病变诊断具有较高的敏感度、特异度及准确性。Objective To determine the accuracy of 16-slice spiral CT in the detection of large bowel diseases with water enema preparation, comparing with colonoscopy and barium enema （BE）. Methods Multislice CT （MSCT） water enema was performed in 43 consecutive patients suspected large bowel diseases, 21 patients received BE examination and 22 patients received colonoscopy examination within one week. Pre-and post-contrast CT scans were performed in all patients. The diagnosis for large bowel disease were made by two experienced gastrointestinal radiologists with consensus. Results Sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of MSCT water enema for diagnosis of large bowel diseases were 86.8%, 80%, 44.4%, 97.1% and 86.1% respectively; of colonoseopy were 80%, 50%, 20%, 94. 1% and 77.3% respectively, of BE were 72.2%, 33.3%, 16.7%, 86.7% and 66.7% respectively. The accuracy for accurate localization in detecting large bowel diseases by MSCT water enema, colonoscopy and BE were 86.1%, 59.1%, 76.2% respectively. There was no significant difference between MSCT water enema and the other two examination methods （MSCT vs BE, P=0. 099, MSCT vs colonoscopy, P=0. 487）, for the accuracy of diagnosing large bowel disease. MSCT water enema was significantly higher than co lonoscopy （P = 0.027） and similar to that of BE （P = 0. 481） for the accurate localization in detecting large bowel diseases. Conclusion MSCT water enema detects large bowel diseases with high sensitivity and specificity. The accuracy for the accurate localization in detecting large bowel diseases by MSCT water enema is higher than colonoscopy and similar to BE.

关 键 词：体层摄影术 X线计算机 结肠水灌肠 钡剂灌肠 结肠镜 大肠病变 

分 类 号：R574.6[医药卫生—消化系统] R814.42[医药卫生—内科学]