低剂量CT仿真结肠镜结合FOBT检查对结直肠癌的诊断价值  

The diagnostic value of low dose CT simulation colonoscopy combined with enhanced scan and FOBT in colorectal cancer

作　　者：邱娅[1] 戴国朝[1] 吴仕吉 周仁冰[1] 阿布都克尤木阿布力孜 郝月 陈青[1] 邹科 努尔阿米娜[1] 张春霞 QIU Ya;DAI Guozhao;WU Shiji;ZHOU Renbing;Abudouke youmu abulizi;HAO Yue;CHEN Qing;ZOU Ke;Nuer amina;ZHANG Chunxia(Image center of the First People's Hospital in Kashgar, Xinjiang 844000, P.R.China)

机构地区：[1]新疆喀什地区第一人民医院影像中心,新疆喀什844000

出　　处：《医学影像学杂志》2021年第1期78-82,共5页Journal of Medical Imaging

基　　金：新疆维吾尔自治区自然科学青年基金(编号:2017D01C015)。

摘　　要：目的探讨低剂量CT仿真结肠镜结合增强扫描(CTVC)及大便潜血检测(fecal occult blood test,FOBT)诊断结直肠癌临床价值。方法选取我院160例结肠占位性病变患者作为观察对象,均行CTVC及FOBT,分析低剂量CTVC、FOBT的临床效果。结果病理学结果显示,160例结直肠占位性病变中,93例为结直肠癌、67例为良性病变。结肠镜阳性检出78例、阴性检出54例,常规CT检出91例、阴性检出58例,低剂量CTVC阳性检出91例、阴性检出58例,结肠镜、常规CT、CTVC与病理学结果的Kappa值分别为0.682、0.857、0.857;此外,低剂量CTVC组同常规剂量组比较,其放射剂量长度乘积(DLP)、有效放射剂量(ED)均显著下降。FOBT阳性检出84例、阴性检出66例,与病理学结果的Kappa值为0.874。低剂量、FOBT的曲线下面积(ACU)、特异度分别为0.922、0.944、0.978、0.683,2者联合的ACU、特异度为0.987、0.989。结论FOBI辅助低剂量CTVC能够提高对结肠癌的诊断效果,且降低患者的辐射剂量,值得临床推广应用。Objective To explore the clinical diagnostic value of low-dose CT simulation colonoscopy combined with enhanced CTVC and FOBT in colorectal cancer patients.Methods 160 patients with colon space-occupying lesions were selected as the research objects in our hospital between September 2017 and March 2020.All underwent CTVC and FOBT test and the clinical results of low-dose CTVC and FOBT were retrospectively analyzed.Results Pathology showed that,of those 160 patients,93 were colorectal cancer and 67 were benign lesions.Colonoscopy detected the positive for 78 and the negative for 54 cases.Conventional CT detected the positive for 91 and the negative for 58 cases;Low doses of CTVC detected the positive for 91 and the negative for 58 cases.The Kappa value of colonoscopy,conventional CT and CTVC as well as pathological results was 0.682,0.857,0.857,respectively.In addition,the products of DLP and ED of low-dose CTVC group were significantly decreased compared with those in the conventional dose group(P<0.05).FOBT detected the positive for 84 and the negative for 66 cases,in which the Kappa value was 0.874 with pathology results.Low dose,the ACU of FOBT,and specific degrees were 0.922,0.944,0.978,0.683,the ACU of the two-joint was 0.987,0.989.Conclusion Low-dose CTVC assisted by FOBI can improve the diagnostic effect of colon cancer and reduce the radiation dose of patients,which is worthy of clinical application.

关 键 词：体层摄影术 X线计算机 大便潜血检测 结直肠癌 

分 类 号：R814.42[医药卫生—影像医学与核医学] R735[医药卫生—放射医学]