摘要
背景:小肠的解剖和生理特点决定了小肠疾病诊断的难度。目的:探讨小肠注气CT成像对小肠疾病的诊断价值。方法:对147例不明原因消化道出血或疑有小肠疾病的患者行小肠注气CT成像。小肠插管至十二指肠末端,缓慢注入气体约1000～1500ml,使小肠充气,肌肉注射654-220mg。行多层螺旋CT(MSCT)快速薄层扫描,螺距15∶16,层厚1mm。行三维图像重建,方法包括容积再现(VR)、多平面重建(MPR)、CT血管成像(CTA)和透明法。对照组94例行常规CT检查,比较两组的病灶发现率。结果:注气CT成像组发现小肠肿瘤38例(间质瘤13例,腺癌14例,淋巴瘤5例,其他肿瘤6例),血管性病变4例,炎性病变5例,梗阻性病变8例,其他病变3例,病灶发现率为39.5%。对照组发现病灶11例,病灶发现率为11.7%。结论:小肠注气CT成像和三维图像重建能提高小肠腔与周围组织的密度差异,增加小肠疾病检测的敏感性,特别有助于小肠肿瘤的检出。
Background： The anatomic and physiologic characteristics of small bowel determine the difficulties in the diagnosis of small bowel diseases. Aims： To investigate the diagnostic value of CT imaging with small intestinal air insufflation in small bowel diseases. Methods： One hundred and forty-seven patients with obscure gastrointestinal bleeding or suspected small bowel diseases underwent CT imaging with small intestinal air insufflation. A naso-enteric catheter was inserted into the distal duodenum, and then 1000-1500 ml of air was insufflated through the tube to distend the small bowel, followed by 20 mg of 654-2 intramuscular injection. Thin-layer muhilayer spiral CT （MSCT） scanning was performed using a pitch of 15：16 and 1 mm thickness. Volume rendering （VR）, muhiplanar reconstruction （MPR）, CT angiography （CTA） and Raysum technique were used as three-dimensional postprocessing techniques. Ninety-four patients underwent common CT scanning served as controls. The detection rates of small intestinal diseases between the two groups were compared. Results： In air insufflation group, 58 lesions were detected, including 38 small intestinal tumors （13 stromal tumor, 14 adenocarcinoma, 5 lymphoma and 6 other neoplasms）, 4 vascular disease, 5 inflammatory lesion, 8 intestinal obstruction and 3 other diseases. The detection rate was 39.5%. In the control group, the detection rate of small intestinal diseases was 11.7% （11/94）. Conclusions： CT scanning with small intestinal air insufflation and three-dimensional image reconstruction can improve the density difference between small intestinal lumen and the surrounding tissues. It is a sensitive method for detection of small bowel diseases, in particular, the small intestinal tumors.
出处
《胃肠病学》
2007年第4期204-208,共5页
Chinese Journal of Gastroenterology
关键词
小肠
肠疾病
低密度对比剂
体层摄影术
螺旋计算机
Intestine, Small
Intestinal Diseases
Low Density Contrast Media
Tomography, Spiral Computed
