CT仿真结肠内窥镜的临床应用研究

目的:研究CT仿真结肠内窥镜(CT Virtual Colonoscopy,CTVC)的使用价值,应用方法及镜下表现。方法:使用Hispeed FX/i扫描机,扫描层厚3～5mm,螺距1～2,重叠重建率50％～67％。利用Navigator Smooth软件对容积扫描数据进行三维重建,获得仿真结肠内窥镜的影像,并与纤维肠镜和/或手术所见对照分析,全部病例经病理证实。结果:通过选择不同的观察方位,角度和阈值,CTVC能清楚显示靶器官内正常解剖结构的立体影像和病变的部位、大小、形态及其侵犯范围。CTVC对结肠病变形态的显示与FC或/和标本显示具有良好的对应性,另外,CTVC能从闭塞和狭窄的远端观察病变。但CTVC不能显示组织的颜色变化,不能活检。结论:CTVC作为一种新的非侵袭性结肠检查方法,可以作为纤维结肠镜的有效补充手段,有较好的临床应用价值。

Research of Clinial Application of CT Virtual Colonoscopy

Objective To investigate the procedure, imaging features and clinical significance of CT virtual colonoscopy. Methods 28 patients and 2 normal volunteers were detected with volume scanning by helical CT (Hispeed Fx/i,GE). The CT scan conditions were collimating with 3~5 mm, pitch 1~2, the raw data of CT volume scan was reconstructed in overlapping rate 50 %~67 % .Volumetric data were analysed by the navigator soft-ware and along the longitudinal axis of the tissues using the soft-ware, Fly through. CTVC images were observed. The diagnosis of all cases were proved by surgery or fiberoptic colonoscopy biopsy. Results The appearances of the inner lesions lesions and normal wall on CTVC of the colon were similar to those on fiberoptic colonoscopy. Additionally, the lesions distal to obstruction could also be evaluated by CTVC, But the CTVC couldn't evaluate mucosa lesion and make histological diagnosis. Conclusion CTVC is a new, non-invasive method for demonstrating the structure of normal and abnormal colon, and it is a good complementary method to conventional fiberopitic colonoscopy.