CT和MR仿真结肠镜技术对比的实验研究  

Experimental study of virtual colonoscopy of simulated mass lesions in pig colon:comparison of CT and MR techniques

作　　者：杨秀军[1] 何之彦[1] 陶勇浩[1] 缪竞陶[1] 陈元炯[1] 胡远胜[1] 王麟川[1] 

机构地区：[1]上海市第一人民医院放射科,200080

出　　处：《中华放射学杂志》2000年第11期785-788,共4页Chinese Journal of Radiology

摘　　要：目的　对比仿真CT结肠镜 (CTVC)和磁共振结肠镜 (MRVC)成像技术及其探查结肠隆起性病变的价值。方法　取长约 2 5cm猪结肠 2段制作出直径为 3～ 12mm的隆起性“病变”模型共2 0个 ,结肠适度充气后以 3mm准直层厚、1 5mm重建间隔、1 0螺距行CT扫描 ;完全水充盈后以相同矩阵、1 5mm层厚行重T2 快速自旋回波序列无间隔扫描。在工作站用导航软件作CTVC和MRVC等后处理。其中 1段结肠同时作了电子结肠镜检查。结果　CTVC和MRVC均类似内窥镜样显示了结肠形态和病变 ,对 3mm及其以上隆起性病变检出率达 10 0 % ,准确性CTVC为 10 0 %、MRVC为71 4% ;结合导航多方位影像 ,准确显示了病灶部位和大小 ,并可靠区分了伪影 ,使MRVC准确性提高至 10 0 %。CTVC显示结肠黏膜和病灶表面细节较MRVC好 (χ2 =4 16 7,P <0 0 5 ) ,但比结肠镜差 (χ2 =5 143,P <0 0 5 )。结论　仿真结肠镜无创性检出了 3mm以上结肠隆起性病变 ,其CT技术优于MR技术 ;结合源影像或其他后处理影像提高了诊断的准确性 。Objective To probe into the techniques and diagnostic value of MR virtual colonoscopy (MRVC) compared with CT virtual colonoscopy (CTVC) and colonoscopy. Methods Two approximately 25 cm long sections of fresh pig colon in vitro had 20 mass lesions created ranging from 3 mm to 12 mm in diameter. MR scanning, as well as CT scanning of the water or air insufflated colon was performed, and CT data were obtained with collimation of 3 mm at a pitch of 1.0 and reconstruction intervals of 1.5 mm. MRI data were acquired with the same matrix and reformating slab, and with heavily T 2 weighted fast spin echo pulse sequences. Postprocessed image sets were performed by the same experienced doctor on a workstation using navigator software based on CT or MRI source imaging data. One section was also underwent electron colonoscopy. Results MRVC and CTVC displayed colon morphology in a manner similar to colonoscopy. The sensitivity of MRVC and CTVC were all 100%, and the accuracy was 71.4% for MRVC and 100% for CTVC. With the combined analysis of the four in one multiview images, they accurately demonstrated the site and size of lesions and distinguished the lesions from the artifacts such as small air bubbles, and the accuracy of MRVC was improved up to 100%. CTVC was better than MRVC ( P <0.05),but both were inferior to colonoscopy in depicting mucosal details of the colon and lesions( P <0.025). Conclusion Virtual colonoscopy (CTVC or MRVC, the former appears better) provided noninvasive endoscope like display of the colon, and permitted identification of colonic mass lesions as small as 3 mm in diameter, the diagnostic accuracy could be improved by combining with source images and other reformations.

关 键 词：结肠 肿瘤 体层摄影术 X线计算机 磁共振成像 图像处理 计算机辅助 对比研究 

分 类 号：R730.44[医药卫生—肿瘤] R735.350.4[医药卫生—临床医学]