能谱CT成像评价末端回肠炎  

Evaluation of terminal ileitis with energy spectrum CT

作　　者：裴申军 吴兴旺[1] 王侠[1] 田晓燕 王斌[2] 梅俏[3] 宋建[1] PEI Shenjun;WU Xingwang;WANG Xia;TIAN Xiaoyan;WANG Bin;MEI Qiao;SONG Jian(Department of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Epidemiology and Statistics,Anhui Medical University,Hefei 230032,China;Department of Gastroenterology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022 [2]安徽医科大学流行病与统计学教研室,安徽合肥230032 [3]安徽医科大学第一附属医院消化内科,安徽合肥230022

出　　处：《中国医学影像技术》2020年第9期1355-1359,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察末端回肠炎宝石能谱CT成像(GSI)表现,并与常规CT小肠造影(CTE)比较,分析其对末端回肠炎的诊断价值。方法回顾性分析120例疑诊末端回肠疾病患者,结肠镜及病理检查显示72例末端回肠炎,6例回盲部息肉或肿瘤样病变,30例回肠克罗恩病及7例回肠肠结核,5例未见明显异常。其中70例接受常规CTE,50例接受GSI,比较其影像学表现。分析2种方法检出末端回肠炎的结果与病理结果的一致性,比较其敏感度和特异度,绘制ROC曲线,并分析其诊断效能。结果相比常规CTE,GSI低keV单能量图像显示病灶较清晰,相应能谱曲线及碘基图能清晰区分病变肠壁、正常肠壁、肠腔液体及邻近脂肪组织;动、静脉期末端回肠炎病变肠壁碘浓度分别为(10.90±0.55)及(14.33±0.75)μg/cm^3。常规CTE及GSI检测末端回肠炎与病理结果的一致性分别为差及较高(Kappa=0.35、0.72,P=0.16、<0.01);GSI检出末端回肠炎的敏感度、特异度(86.21%、85.71%)均高于常规CTE(65.12%、51.85%,χ^2=3.97、6.10,P均<0.05)。GSI检出末端回肠炎的AUC(0.86)高于常规CTE(0.57,Z=2.42,P=0.02)。结论GSI能清晰显示末端回肠炎病灶,对末端回肠炎有较高诊断效能。Objective To observe the manifestations of terminal ileitis on gemstone energy spectrum CT imaging(GSI)and its diagnostic efficacy compared conventional CT enterography(CTE),so as to evaluate the diagnosis value of GSI for terminal ileitis.Methods Data of 120 patients with suspected terminal ileum diseases were retrospectively analyzed,including 115 cases of pathologically proved diseases(72 cases of terminal ileum enteritis,6 cases of ileum polyps or tumorlike lesions,30 cases of ileum Crohn's disease and 7 cases of ileum tuberculosis)and 5 cases without obvious abnormality.Among them 70 patients received conventional CTE(CTE group)and 50 received GSI(GSI group).Imaging characteristics of terminal ileitis were observed and compared between 2 groups.The consistency of the results of 2 methods for detecting terminal ileitis with pathological results were analyzed,and their sensitivities and specificities were compared.ROC curves of 2 methods for detecting terminal ileitis were drawn,and their relative diagnostic efficacy were analyzed.Results Compared with conventional CTE,the lesions were clearer on low keV single energy imaging.The energy spectrum curve and iodide maps clearly identified the lesion’s wall,normal wall,the fluid in intestinal cavity and the adjacent fat tissue.The iodine concentration of terminal ileitis at the arterial and venous phase was(10.90±0.55)μg/cm^3 and(14.33±0.75)μg/cm^3,respectively.Conventional CTE showed poor,while GSI showed high consistency with the pathological results for detecting terminal ileitis(Kappa=0.35,0.72,P=0.16,<0.01).The sensitivity and specificity of GSI(86.21%,85.71%)were bith higher than those of conventional CTE(65.12%,51.85%,χ^2=3.97,6.10,both P<0.05).The AUC of GSI(0.86)was higher than that of conventional CTE(0.57,Z=2.42,P=0.02).Conclusion GSI could clearly show lesions of terminal ileitis,therefore having high diagnostic efficacy for detecting terminal ileitis.

关 键 词：回肠炎 体层摄影术 X线计算机 能谱成像 

分 类 号：R574.53[医药卫生—消化系统] R814.42[医药卫生—内科学]