螺旋CT仿真内窥镜诊断膀胱肿瘤(动物实验和临床对照研究)  

Computed Tomography Virtual Cystoscopy in the Detection of Bladder Cancer (Animal Experiment and Clinical Study)

作　　者：赵素红[1] 刘庆伟[1] 崔允峰[1] 宋鸿彬[1] 杨玉海[1] 李艳[1] 吴梅[1] 

机构地区：[1]山东大学第二医院影像科,山东济南250033

出　　处：《实用放射学杂志》2004年第1期1-4,共4页Journal of Practical Radiology

摘　　要：目的　研究螺旋CT仿真内窥镜技术 (CTVE)在早期诊断膀胱肿瘤中的价值。方法　动物实验于狗膀胱的不同位置造成6个 5mm直径结节 ,膀胱排尿充气后扫描 ,盲法评价CT横断面和仿真内窥镜图像显示膀胱结节的异同 ,统计处理其结果。临床病例通过导尿管排出尿液向膀胱内注入气体后行螺旋CT扫描 ,图像传至工作站行三维仿真膀胱镜重建。盲法评价CTVE和横轴位图像显示膀胱内肿瘤结节病变检出数量的差异 ,以及 2种方法提供的信息情况。结果　动物实验横断面和CTVE像均显示出 6个结节。临床 2 0例中证实膀胱肿瘤 18例 ,CTVE均发现而轴位像仅发现 14例。CTVE检出 3 1个结节 ,轴位像仅检出 2 6个 ,5个直径≤ 5mm的结节轴位像均漏诊 ,两者有差异 (Ρ <0 .0 5 )。CTVE的敏感性和阴性预测值均为 10 0 % ;横断面图像的敏感性和阴性预测值仅为 77.8%和 3 3 .3 %。结论　CTVE为一种无创检查 ,无盲区 ,对膀胱肿瘤的检测是一种有效的方法 ,与CT横断面图像结合可为膀胱肿瘤的早期发现和合理治疗提供准确信息。Objective To investigate the value of computed tomography virtual cystoscopy (CTVE) in the detection of bladder cancer . Methods Six nodules of 5 mm in diameter were created in the different areas of the bladder of the experiment dog, which was scanned by spiral CT.The numbers of nodule on both transverse and virtual images were observed by 5 doctors independeatly. 20 patients with clinically suspected bladder tumor were examined with CTVE. The bladders insufflated with 250～500 ml air through a catheter were scaned . The data were downloaded to a workstation for interacactive intraluminal navigation. The results of transverse images and CTVE were also evaluated by five doctors independently. Results All six nodules in 6 dogs were displayed by both transverse and virtual images, but the virtual images showed those nodules much better .Thirty-one lesions in 20 patients were identified on the CTVE including five lesions of less than 5 mm in diameter, but only 26 on the transverse images. On axial image,the sensitivity and negative predictive value were 77.8% and 33.3% respectively. The sensitivity and negative predictive value were all 100% on CTVE.Conclusion CTVE is a effective and useful tool in the detection of bladder tumor.Transverse images combined with virtual images is neccessary because they are complementary in the detection of bladder tumor.

关 键 词：螺旋CT仿真内窥镜 诊断 膀胱肿瘤 动物实验 体层摄影 X线计算机 

分 类 号：R737.14[医药卫生—肿瘤] R814.42[医药卫生—临床医学]