口服法小肠灌肠CT检查的诊断价值研究  

Small-bowel Diseases: Evaluation of Multi-detector Helical CT with Oral Contrast

作　　者：朱炯[1] 龚红霞[1] 周滟[1] 华佳[1] 路青[1] 柴伟明[1] 许建荣[1] 

机构地区：[1]交通大学医学院附属仁济医院放射科

出　　处：《中国医学计算机成像杂志》2007年第2期100-104,共5页Chinese Computed Medical Imaging

基　　金：上海市科委项目(034119905)~~

摘　　要：目的:评价口服法小肠灌肠CT检查对小肠病变的诊断价值。材料和方法:研究的对象包括2003年1月-2005年3月间53例临床怀疑有小肠病变而行小肠CT检查的患者。扫描前20-30min口服混合溶液(每1000ml由20%甘露醇250ml+5%糖盐水500ml+水250ml所配成)约2000ml充盈小肠。首先,对小肠的扩张程度进行评价;其次,通过横断位及多平面重建,从局限性或弥漫性肠壁增厚、小肠肿块、小肠系膜扭转、肠系膜淋巴结肿大、远处转移几方面进行征象分析,并作出诊断。分别计算小肠CT检查的敏感度、特异度、阳性预测值和阴性预测值。结果:小肠扩张最佳的24例(24/53),扩张良好的25例(25/53),扩张欠佳的4例(4/53),无扩张0例(0/53);口服肠道准备小肠CT检查的敏感度为97.6%(40/41),特异度为75%(9/12),阳性预测值为93.0%(40/43),阴性预测值为90.0%(9/10)。结论:口服肠道准备小肠螺旋CT检查方能够很好满足诊断需要,对小肠病变具有诊断价值。Purpose： To prospectively evaluate multi - detector helical computed tomographic （CT） with oral contrast for the depiction of small - bowel diseases. Materials and Methods： The study group included 53 patients who were suspected of small - bowel disease from January, 2003 to March, 2005.All patients ingested a special mixture of mannit, glucose saline and water 2000ml for distention of the small bowel before CT scan.At first, the degree of small bowel distention , as seen on transverse CT images, was graded by means of a four - point scale. The second, transverse and multiplanar reformatted CT images were specifically analyzed for the presence of focal or diffuse bowel wall thickening, small - bowel masses, mesenteric stranding, enlarged mesenteric lymph nodes, and visceral metastasis, then, the diagnosis was made. The sensitivity, specificity, positive predictive value, and negative predictive value of multi - detector helical CT were calculated. Results： The degree of small - bowel distention varied from optimal in 24 of 53 patients, to good （a score of 2） in 25 of 53 patients, to poor （a score of 1） in 4 of 53 patients, and no one no distention. Sensitivity, specificity, positive predictive value, and negative predictive value of multi - detector helical CT with oral contrast were 97.696, 7596, 93.096, and 90.096, respectively. Conclusion： Multi -detector helical CT with oral contrast allows depiction of small- bowel diseases in patients suspected with abnormal small - bowel conditions.

关 键 词：肠疾病 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]