胶囊内镜和CT仿真内镜诊断小肠疾病的对照研究

目的评价胶囊内镜和cT仿真内镜（CTVE）在小肠病变诊断方面的临床应用价值。方法回顾性总结3l例临床怀疑小肠疾病行胶囊内镜和CTVE检查患者的临床资料，参照最终诊断结果（手术病例以病理诊断为金标准，非手术病例依据后续检查及随访结果给出最终诊断）统计胶囊内镜、CTVE以及二者联合的诊断阳性率并行对比分析。结果最终诊断阳性26例，包括小肠肿瘤性病变16例、非肿瘤性病变10例，阴性5例。胶囊内镜诊断阳性24例，包括小肠肿瘤性病变14例（其中2例定位不准确，7例不能定性）和非肿瘤性病变10例；CTVE诊断阳性17例，包括小肠肿瘤性病变14例（其中1例定位不准确，4例不能定性）和非肿瘤性病变3例；胶囊内镜联合CTVE诊断阳性26例，包括小肠肿瘤性病变16例、非肿瘤性病变10例。对于小肠肿瘤性病变，胶囊内镜和CTVE诊断阳性率相同，均为87．5％（14／16）；而在总体诊断阳性率方面，胶囊内镜为77．4％（24／31），CTVE为54．8％（17／31），胶囊内镜联合CT仿真内镜为83．9％（26／31），二者联合总体诊断阳性率明显高于CTVE（P=0．004），但与胶囊内镜比较差异无统计学意义（P〉0．05），胶囊内镜与CTVE比较差异也无统计学意义（P=0．065）。结论胶囊内镜和CTVE均有助于小肠疾病的诊断，胶囊内镜在诊断小肠非肿瘤性病变方面更有优势，而CTVE在判断小肠肿瘤性病变的位置和结构方面优于胶囊内镜，二者联合使用可进一步提高检出小肠疾病的能力。

Comparative study of capsule endoscopy and CT virtual endoscopy in diagnosis of small intestinal diseases

Objective To assess the diagnostic value of capsule endoscopy （CE） and CT virtual endoscopy （CTVE） for small intestinal diseases. Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected. The diagnostic rates of CE and CTVE was compared by paired data McNemar test, using the diagnosis confirmed by surgery or follow-up as the golden standard. Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16, non- tumorous lesion in 10 and no abnormal lesion in 5. CE identified positive findings in 24 patients, including 14 cases of tumorous lesion （ with mis-location in 2 and failure in definite diagnosis in 7 ） and 10 cases of non-tumorous lesion. CTVE identified positive findings in 17 patients, including 14 cases of tumorous lesion （ with mis-location in 1 and failure in definite diagnosis in 4） and 3 cases of non-tumorous lesion. The com- bination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 non- tumorous lesions. The diagnostic rates of CE and CTVE for tumorous lesions were both 87. 5% （14/16）. The overall diagnostic rate of combined CE and CTVE was 83.9% （26/31） , which was significantly higher than that of CTVE alone （54. 8%, 17/31 ） but similar to that of CE alone （77.4%, 24/31 ）. Conclusion BothCE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can in- crease diagnosis yield.