双气囊内镜与多层螺旋CT小肠造影在小肠克罗恩病诊断中的作用  

Value of double-balloon endoscopy and multi-slice CT enteroclysis in diagnosis of Crohn＇s disease in small intestine

作　　者：徐姝琪[1] 钟捷[1] 唐永华[2] 缪飞[2] 程时丹[1] 张曙[1] 王立夫[1] 张晨莉[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化科,200025 [2]上海交通大学医学院附属瑞金医院放射科,200025

出　　处：《中华消化杂志》2009年第9期517-520,共4页Chinese Journal of Digestion

摘　　要：目的研究双气囊内镜（DBE）和多层螺旋CT小肠造影（MSCTE）在小肠克罗恩病（CD）诊断中的价值。方法对71例临床疑似小肠CD患者分别进行DBE和MSCTE检查并作出诊断。结合病理及临床随访结果，比较两种方法在小肠CD诊断、判断病变范围、活动性和并发症等方面的能力。结果DBE与MScTE对小肠CD确诊率相似，两者间差异无统计学意义（χ^2=2．29，P〉0．05）。前者阳性似然比为22．5，阴性似然比为0．022；后者阳性似然比为1．6，阴性似然比为0．240。两种检查方法对于无轻度管腔狭窄者判断的一致性明显高于中一重度管腔狭窄者（χ^2=1i．298，P=0．001）。DBE与MSCTE对疾病活动性判断的一致性为95．8％。结论DBE可能是确诊小肠CD的首选方法，与MSCTE联合应用有利于诊断和评价小肠CD患者的病情。Objective To investigate the value of double-balloon endoscopy （DBE） and multi slice CT enteroclysis （MSCTE） in diagnosis of Crohn＇s disease （CD） in small intestine. Methods DBE and MSCTE were performed in 71 patients with suspected Crohn＇s disease in small intestine. The two methods were compared in terms of diagnosis, extents of disease, existance of complications and activity of the disease according to the pathologic findings and the outcome of follow-up. Results The diagnostic yields of DBE and MSCTE were comparable with no significant difference χ^2=2.29, P〉 0.05）. The positive and negative likelihood ratios were 22.5 and 0. 022 in DBE respectively, and were 1.6 and 0. 240 in MSCTE respectively. The results of DBE was consistent with MSCTE in diagnosis of mild bowel stenosis, but was inconsistent with MSCTE in diagnosis of moderate-severe bowel stenosis （χ^2= 11. 298, P=0. 001）. The concordance of two methods in diagnosis of disease activity was 95.8%. Conclusions The first choice in diagnosis of small bowel CD is DBE. The combination of two methods will be helpful in diagnosis and evaluation of CD severity.

关 键 词：克罗恩病 内镜检查 胃肠道 体层摄影术 螺旋计算机 

分 类 号：R686[医药卫生—骨科学]