256层多排螺旋CT小肠成像（MDCTE）对小肠疾病的诊断价值

目的:探讨256层多排螺旋CT小肠造影(MDCTE)扫描技术在小肠疾病诊断中的临床应用价值。材料和方法:对118例临床怀疑小肠疾病患者,男53例,女65例,平均年龄48.5岁。行256-MDCTE平扫及增强扫描,通过横断面及多平面重建,观察病变部位、大小、形态、周围侵犯及转移情况,结果与最终临床诊断对照分析。结果:本组118例患者中,56例MDCTE诊断为小肠病变,并与最终临床诊断相符。另外62例MDCTE诊断为阴性,其中47例符合,9例漏诊,6例误诊。并且通过统计分析得出MDCTE对小肠疾病诊断的灵敏度为78.87%(56/71),特异度为100%(47/47),正确率为87.29%((56+47)/118),阳性预测值为100%(56/56),阴性预测值为75.80%(47/62)。结论:小肠肿瘤、炎症、肠梗阻等病变在MDCTE上具有特征性的表现,MDCTE对小肠疾病的临床诊治具有重要价值。

Application Study of 256 Multidetector-Row Computed Tomography Enterography (MDCTE) in Small Bowel Diseases

Purpose:To discuss the utility of MDCTE for evaluating diseases of the small bowel.Materials and methods:At our institution,118 patients(male 53;female 65;mean age 48.5 years) with symptoms of suspected small bowel diseases underwent 256-MDCTE.Pertinent MDCTE and histopathology reports were reviewed.The CT appearances characteristic of small-bowel tumor,inflammatory bowel disease and other conditions affecting the small bowel are described and illustrated in detail.Associated complications and extraenteric manifestations also are described.Results:Of 118 MDCTEs performed,the sensitivity,specificity,positive and negative predictive values and accuracy of visual assessment for small bowel disease were 78.87%(56/71),100%(47/47),100%(56/56),75.80%(47/62),and 87.29%((56 + 47)/118),respectively.Conclusion:Our results demonstrated that MDCTE with oral and intravenous contrast is useful in assessing small bowel diseases;however,further studies are needed to determine and validate the full diagnostic and clinical potential of bowel imaging at MDCTE.