256层多排螺旋CT小肠成像(MDCTE)对小肠疾病的诊断价值  

Application Study of 256 Multidetector-Row Computed Tomography Enterography(MDCTE) in Small Bowel Diseases

作　　者：窦娅芳[1,2] 唐颖[1] 解骞[1] 朱全东[1] 祝瑞江[1] 梁宗辉[1,3] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]上海交通大学附属第一人民医院放射科,上海200080 [3]上海市静安区中心医院放射科(复旦大学附属华山医院静安分院),上海200040

出　　处：《CT理论与应用研究（中英文）》2013年第1期137-146,共10页Computerized Tomography Theory and Applications

摘　　要：目的:探讨256层多排螺旋CT小肠造影(MDCTE)扫描技术在小肠疾病诊断中的临床应用价值。材料和方法:对118例临床怀疑小肠疾病患者,男53例,女65例,平均年龄48.5岁。行256-MDCTE平扫及增强扫描,通过横断面及多平面重建,观察病变部位、大小、形态、周围侵犯及转移情况,结果与最终临床诊断对照分析。结果:本组118例患者中,56例MDCTE诊断为小肠病变,并与最终临床诊断相符。另外62例MDCTE诊断为阴性,其中47例符合,9例漏诊,6例误诊。并且通过统计分析得出MDCTE对小肠疾病诊断的灵敏度为78.87%(56/71),特异度为100%(47/47),正确率为87.29%((56+47)/118),阳性预测值为100%(56/56),阴性预测值为75.80%(47/62)。结论:小肠肿瘤、炎症、肠梗阻等病变在MDCTE上具有特征性的表现,MDCTE对小肠疾病的临床诊治具有重要价值。Purpose： To discuss the utility of MDCTE for evaluating diseases of the small bowel. Materials and methods： At our institution, 118 patients （male 53; female 65; mean age 48.5 years） with symptoms of suspected small bowel diseases underwent 256-MDCTE. Pertinent MDCTE and histopathology reports were reviewed. The CT appearances characteristic of small-bowel tumor, inflammatory bowel disease and other conditions affecting the small bowel are described and illustrated in detail. Associated complications and extraenteric manifestations also are described. Results： Of 118 MDCTEs performed, the sensitivity, specificity, positive and negative predictive values and accuracy of visual assessment for small bowel disease were 78.87% （56/71）, 100% （47/47）, 100% （56/56）, 75.80% （47/62）, and 87.29% （（56 ＋ 47）/118）, respectively. Conclusion： Our results demonstrated that MDCTE with oral and intravenous contrast is useful in assessing small bowel diseases; however, further studies are needed to determine and validate the full diagnostic and clinical potential of bowel imaging at MDCTE.

关 键 词：小肠 多层螺旋CT 小肠疾病 

分 类 号：R574[医药卫生—消化系统]