小肠空气灌肠双源CT检查与胶囊内镜小肠检查对比研究
The Research of Comparision between Dual Source CT Air Enema Intestinal Examination and Capsule Endoscopy Small Bowel Examination
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摘要: 目的:探讨小肠空气灌肠双源CT检查对小肠疾病的诊断价值。方法:15例临床怀疑小肠病变的患者,行双源CT检查前或后3天内行胶囊内镜检查。其中,男8例,女7例,年龄最大者42岁,最小者23岁。症状主要为腹痛10例,脓血便4例,不明原因消瘦1例,病程最长4年,最短1月。结果:胶囊内镜未见异常8例,双源CT检查亦未见异常;双源CT诊断克罗恩病4例,与胶囊内镜及临床诊断一致;胶囊内镜可疑肿瘤3例,双源CT发现2例并作出良恶性诊断,其中1例为空肠间质瘤,1例为回肠腺癌,经手术病理证实;仅1例胶囊内镜可疑3cm大小肿瘤,双源CT未见异常,结合MRI检查及临床,证实为假阳性。结论:小肠空气灌肠双源CT检查,不仅可以显示小肠器质性病变范围、与邻近结构的关系,而且可以结合临床鉴别炎性病变与肿瘤性病变,并对肿瘤性病变做出良恶性鉴别;还可以为胶囊内镜所见病变定位及排除假阳性问题。Abstract: Objective: To evaluate the value of the dual source CT air enema intestinal examination in the diagnosis of small bowel diseases.Methods: 15 patients with suspected small bowel diseases underwent dual-source CT inspection before or after the capsule endoscopy within 3 days.Among them,8 males and 7 females,the oldest 42 years old,the youngest 23 years old.The major symptoms were abdominal pain in 10 cases,blood and pus stool in 4 cases,1 case of unexplained weight loss,the longest duration was 4 years and the shortest was 1 month.Results: Capsule endoscopy showed normal in 8 cases,dual-source CT examination were no exception.Dual-source CT diagnosed Crohn diseases in 4 cases,clinical diagnosis with capsule endoscopy were the same.Capsule endoscopy suspected tumors in 3 cases,but dual-source CT examination only found two positive cases,with diagnosis of benign and malignant,of which,confirmed by pathology,1 was jejunum stromal tumors,another was ileal adenocarcinoma.Only one case with 3cm size was suspected the tumor in capsule endoscopy,but in dual source CT was normal.Combined with MRI,and clinical history,the issue was proved to be false positive.Conclusion Dual source CT air enema intestinal examination could not only show the scope of the relationship with adjacent structures,and identify clinical inflammation and cancer lesions,and make the tumor differentiation of benign and malignant lesions.The examinations are also valuable for capsule endoscopy to confirm localization and scope of lesions,and rule out false positive.