肠系膜CT血管成像对原发性小肠占位性病变的诊断效果  

Mesenteric CT angiography for diagnosis of primary small intestinal space-occupying lesions

作　　者：王柏平[1] 陈宏才[1] 

机构地区：[1]海南省农垦总医院放射科,海南省海口市570311

出　　处：《世界华人消化杂志》2015年第6期1000-1004,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨肠系膜计算机断层扫描(computed tomography,CT)血管成像对老年患者原发性小肠占位性病变的诊断效果.方法:回顾性分析100例老年原发性小肠占位病变患者的临床资料,观察不同类型的病变的肠系膜CT血管成像表现.2名医师采用供血动脉定位法和Coles分组定位法分别进行病变定位诊断,对比不同方法和医师的诊断准确性.结果:100例小肠占位性病变患者的CT血管成像结果显示,28例出现供血动脉变粗,21例出现引流静脉增粗、迂回,29例产生肿瘤血管,47例发生肠系膜侧直小血管增多和变粗.供血动脉定位法和Coles分组定位法的定位准确率分布为99.0%和85.0%,在十二指肠和回盲部均准确定位.Coles分组定位法在回肠和空肠的定位准确率相对较低(76.6%和55.6%).2名医师采用供血动脉定位法进行老年小肠占位性病变具有高度一致性(Kappa=1.00,P=0.000),采用Coles分组定位法具有中度一致性(Kappa=0.54,P=0.000),2名医师采用供血动脉定位法和Coles分组定位法的定位准确性差异无统计学意义(P>0.05).结论:采用肠系膜CT血管成像技术能够明显显示出原发性小肠占位性病变的供血动脉等血管情况,有助于定位和定性诊断.AIM： To investigate the diagnostic value of mesenteric computed tomography （CT） angiography in elderly patients with primary small intestinal space-occupying lesions. METHODS： A retrospective analysis was performed of 100 elderly patients with primary small intestinal lesions who underwent mesenteric CT angiography. Two radiologists localized and diagnosed the lesions using artery location method and Cole＇s method. The diagnostic accuracy was compared betweendifferent methods and radiologists RESULTS： Of the 100 cases of small intestinal lesions detected by CT angiography, 28 showed arterial enlargement, 21 showed venous enlargement and tortuosity, 29 produced tumor vessels, and 47 had enlargement and thickening of the vasa recta on the mesenteric side. The accuracy of artery location method and Cole＇s method was 99% and 85%, respectively, and both were accurate in venous localization in the duodenum and ileocecal regions. The accuracy of the artery location method was relatively low in the ileum and jejunum （76.6% and 55.6%）. Two radiologists had high consistency （Kappa = 1.00, P = 0.000） when using the artery location method, and moderate consistency （Kappa = 0.54, P = 0.000） when using the Coles method. There was no significant difference in localization accuracy between the two physicians （P 〉 0.05）. CONCLUSION： Mesenteric CT angiography can clearly show the blood supplying vessels of primary small intestinal lesions and therefore contribute to the localization and qualitative diagnosis of these lesions.

关 键 词：肠系膜 血管成像 小肠占位性病变 

分 类 号：R574.5[医药卫生—消化系统] R816.5[医药卫生—内科学]