口服肠溶气钡胶囊法在小肠双对比造影中的研究

目的：研究一种新的、简便易行的小肠双对比造影法—口服肠溶气钡胶囊法小肠气钡双对比造影。方法：采用零号肠溶空心胶囊,装入不同比例的产气粉和医用硫酸钡粉,制成Ⅰ号、Ⅱ号、Ⅲ号3种＂肠溶气钡胶囊＂（以下简称胶囊）。通过数字胃肠机直接动态观察并记录Ⅰ号、Ⅱ号、Ⅲ号胶囊在各段小肠内的定位崩解的过程以及释放CO2气体的情况,最终获得各段小肠的最佳的气钡双对比造影图像。对120名志愿者行小肠造影,随机分为研究组（60例）和对照组（60例）。研究组采用胶囊法,对照组采用传统口服钡剂法。结果：研究组49例效果满意或基本满意,11例未观察到明显双对比效果,总有效率81.67%;对照组均为单钡剂造影效果。结论：口服胶囊法小肠气钡双对比造影能形成良好的气钡双对比影像,所获图像效果较传统口服钡剂法有明显提高。     

无管法快速小肠气钡双对比造影法的研究

目的研究一种新的、简便易行的小肠双对比造影法——无管法快速小肠气钡双对比造影法。方法将产气粉装入小肠溶胶囊,口服并在小肠内崩解,释放二氧化碳气体,配合口服钡剂及西沙必利,形成小肠双对比像。选取130例拟行小肠造影检查者,随机分为研究组和对照组,研究组67例采用本法,对照组63例采用口服钡剂法加肌注胃复安。结果研究组53例效果满意,12例基本满意,2例未观察到明显双对比效果,其中1例因吞咽困难无法检查,总有效率97.02%,平均检查时间(34.63±16.66)m in;对照组均为单钡造影效果,平均检查耗时(77.12±32.98)m in;2种检查方法耗用时间及2种药物的效果在统计学上具有显著性差异(P<0.01)。结论无管法快速小肠气钡双对比造影法确能形成良好的气钡双对比像,小肠观察效果较口服钡剂法有明显提高。     

中药玄明粉在小肠双对比造影中的应用价值

目的 探讨中药玄明粉在小肠双对比造影中的应用价值.资料与方法 对随机抽查80例临床疑为小肠疾病患者,分两组:40例采用造影前2h口服玄明粉15 g(玄明粉组),40例常规口服法小肠双对比造影(对照组).对比剂均采用口服混悬钡,浓度为60%(W/V),总量350 ml,产气粉9g,进行对比.结果 口服玄明粉后可明显缩短造影时间;小肠清洁率优于对照组;病变显示率92.5%(37/40)显著高于对照组47.5%(19/40).结论 造影前口服中药玄明粉能使小肠清洁,缩短造影时间,明显提高了小肠疾病的检出率.     

改良法小肠气钡双对比造影

在胃肠疾病诊断中,小肠病变是唯一只能依赖X 线检查而不能用其他检查手段替代,因此提高小肠气钡双对比造影质量对发现小肠病变尤为重要.常规口服法因钡多气少,主要显示充盈像,对管腔内细小病变显示欠佳,并且因肠袢重叠易遗漏病变;插管法虽然能取得良好的双对比效果,但操作复杂,患者难以耐受[4～6].笔者在实践中参照Phillips[1～3]的报道,使用小肠改良法气钡双重造影能较满意地显示小肠的气钡双对比像.     

胃镜引导插管小肠双对比造影方法研究

目的：探讨小肠双对比造影检查的有效方法。方法：72例受检者被随机分成2组；试验组(36例)应用研制的小肠造影导管，在胃镜直视下钳夹导管头端并送达十二指肠水平部，头端气囊充气固定导管，退出胃镜后，经导管灌注适量稀钡胶浆及空气行小肠双对比造影。对照组(36例)采用改进的F9心导管在透视下插管。结果：实验组插管成功35例(成功率97．1％)，对照组插管成功27例(成功率75％)。结论：研制专用的小肠造影导管并经胃镜引导插管行小肠双对比造影检查，其成功率明显高于普通插管方法。     

口服法气钡双重造影对小肠病变的诊断价值

目的：探讨口服法气钡双重造影对小肠病变的诊断价值及几种小肠病变的影像特征。方法：回顾性分析26例小肠病变患者的临床表现与造影影像特征及手术病理结果的相互关系。全部病人均行口服法小肠气钡双重造影检查，2例行CT检查，病例均经治疗确诊或病理证实。结果：26例中，临床有18例消化道出血，5例间断性脐周疼痛，2例不全性肠梗阻，1例外伤后呕吐来诊。其中腺癌5例，类癌2例，平滑肌肉瘤3例，间质瘤1例，腺瘤或息肉4例。淋巴管扩张症、肠结核、克隆氏病各2例，血管瘤、神经节细胞瘤、小肠结石、外伤后肠狭窄、重复小肠各1例，其影像表现各具特征。结论：小肠气钡双重造影检查对小肠腔内及管壁受累病变有重要价值；而病变起自肠壁且向腔外生长者需结合B超及CT检查方能作出诊断。     

小肠原发性肿瘤的影像诊断(附30例分析)

目的:探讨小肠原发性肿瘤的影像学特征及检查方法。方法:30例均行口服法小肠气钡双对比造影检查,其中2例行CT扫描,1例行MRI检查,全部病例均经手术病理证实。结果:30例中,腺癌9例,平滑肌肉瘤5例,腺瘤或息肉7例,类癌、间质瘤、管状腺瘤、神经节细胞瘤各2例,血管瘤1例。发生于十二指肠15例,空肠13例、回肠2例。恶性肿瘤多表现为:肠黏膜破坏,腔内或腔外不规则龛影,肠管局限性狭窄,壁僵硬,蠕动消失。良性肿瘤多表现为:肠腔内圆形、卵圆形充盈缺损,边缘光滑,形态可变,黏膜平坦。肠壁软,蠕动正常。肿瘤向肠腔外生长者B超、CT、MRI检查占有优势。结论:对临床疑诊为原发性小肠肿瘤者应首选小肠气钡双对比造影检查,小肠双对比造影检查与CT扫描相结合可提高诊断准确率。     

数字化小肠气钡造影在小肠病变中的诊断价值

目的 评价数字化小肠气钡造影在诊断小肠病变中的用途。方法 22例经手术病理证实的小肠病变，其中，恶性病变10例，良性病变12例，均经数字化小肠气钡造影。结果 在22例患者中，数字化小肠气钡造影正确诊断19例，1例空肠腺癌被误诊为炎症，2例空肠增殖性结核被误诊为恶性占位性病变。诊断敏感性、特异性、准确率、阳性预测值以及阴性预测值分别为80%，92%，87%，89%以及92%。结论 数字化小肠气钡造影对小肠病变具有较高的诊断与鉴别诊断能力，对临床上疑有小肠病变的患者应作为首选方法。     

无管法小肠气钡双对比灌肠造影术63例分析

目前大多数采用插管注入稀钡及气体进行双对比造影检查,因过程繁琐,患者遭受痛苦大而难以接受检查.为此,笔者参照Philps的报道[1,2],改进运用无管法进行小肠气钡双对比造影检查63例,效果良好,现报告如下:     

口服动力性等渗稀钡液小肠快速双对比造影术临床研究

目的:探讨口服动力性等渗稀钡液小肠快速双对比造影术的临床应用价值。方法:将143例小肠造影患者随机分为2组:研究组74例,对照组69例。分析比较2组的影像图像质量满意度及莫沙必利、胃复安的药效。结果:研究组与对照组相比,图像质量满意度高,χ2检验,P<0.001,说明2种检查方法差异有统计学意义;新一代全胃肠动力药莫沙必利在小肠造影中的促排作用明显优于胃复安,t检验,P<0.001,说明2组所用时间差异有统计学意义,即莫沙必利可大大缩短检查时间。结论:口服动力性等渗稀钡液小肠快速双对比造影术与传统小肠造影相比,图像质量高,检查时间短,简便、节约、环保,是小肠疾病的有效检查方法。     

内镜导引下插管小肠双对比造影50例分析

目的:通过改进小肠插管技术,提高小肠检查率和小肠病变的发现率。方法:经胃内镜引导把B-D导管置入空肠上部。结果:50例病人插管成功率100%(50/50);满意率98%(49/50);病变阳性率86%(43/50)。结论:胃内镜导引下小肠插管双对比能明显提高小肠检查率和小肠病变发现率,可作为常规应用。     

Progress in radiology: colorectal tumors: pathology and detection.

The prognosis in colorectal neoplasia has not improved in the past 20 years despite improved diagnostic techniques. The greatest promise lies in wider screening and earlier radiographic and endoscopic detection. To clarify the radiologist's role in finding large bowel tumors, the clinical, pathologic, and radiologic literature is reviewed. Since individuals over 40 years of age harbor the bulk of colon neoplasms, the most diligent efforts to detect these lesions should be made in this group. Controlled studies comparing single and double contrast barium enema techniques are lacking, but available data suggest that the double contrast examination is more sensitive for detection of the numerous small, but potentially malignant colon tumors. Careful radiographic technique, including a thoroughly clean colon, is critical for accurate detection regardless of which technique is used.     

Accelerating the transit time of barium sulphate suspensions in small bowel examinations

PURPOSE: To determine whether hyperosmolar and effervescent agents proven individually to accelerate transit time in the barium small bowel examination have an additive effect when combined, surpassing that of either agent alone. MATERIALS AND METHODS: One hundred and forty-nine patients were randomised to four groups. Three hundred milliliters of barium sulphate alone was given to the first group. Fifteen milliliters of iodinated hyperosmolar contrast agent (Gastrografin, meglumine/sodium diatrizoate, Schering) was given in addition to barium sulphate to the second group while six packets of effervescent granules (Carbex, Ferring) were added for the third group. The final group was given a combination of both additives and barium sulphate. The time taken following ingestion for the contrast column to reach the caecum, as assessed by frequent interval fluoroscopy, was recorded. A subgroup of 32 patients were selected randomly from the four groups, 8 from each and assessed for quality of examination. Statistical assessments were made using Kruskal-Wallis and Mann-Whitney tests. RESULTS: One hundred and nineteen patients were analysed after exclusions. The addition of accelerant to barium sulphate, both individually and in combination significantly reduced the small bowel transit time (p<0.001). No significant difference existed between the additives when used with barium alone. The combined group had significantly faster transit times compared to the hyperosmolar group (p=0.02). Differences between combined and effervescent groups tended towards significance (p=0.09). No significant difference existed between groups when examination quality was assessed. CONCLUSION: These results suggest that the addition of combined effervescent and hyperosmolar agents to the barium suspension may significantly shorten the small bowel transit time without adversely affecting examination quality. This has implications for patient acceptability of the examination as well as potentially reducing screening time and therefore radiation dose.     

MSCT与气钡双重造影在小肠不明原因出血中的诊断价值

目的 评价多层螺旋CT扫描结合小肠气钡双重造影检查在小肠出血诊断中的价值.方法 对我院经胃镜及结肠镜检查未能明确的消化道出血患者行腹部CT并结合小肠气钡双重造影检查.结果 腹部多层螺旋CT检查及小肠气钡双重造影检查的诊断符合率分别为74.1％及55.2％.结论 采用腹部螺旋CT检查结合小肠气钡双重造影检查可以提高小肠出血的诊断符合率.     

Is carbon dioxide as an insufflation agent for double contrast barium enema still worthwhile after a same-day flexible sigmoidoscopy?

PURPOSE: The aim of the study was to evaluate the efficacy of a double-contrast barium enema (DCBE) with CO(2) as a distending gas after a screening flexible sigmoidoscopy for reducing abdominal distension after an examination. PATIENTS AND METHODS: A total of 165 DCBEs for patients with positive faecal occult blood tests were randomly allocated to a CO(2) group (n = 83) and a control group (n = 82) using air. Abdominal radiograph were taken before the DCBE, immediately following it, and 30 minutes later to determine residual bowel gas. The degree of abdominal discomfort was recorded using a scoring system. RESULTS: The patients in the CO(2) group had significantly smaller amounts of residual gas 30 minutes after the DCBE than did the control group, both in the colon (P < 0.02) and in the small intestine (P < 0.001). There was significantly less abdominal distension after the DCBE in the CO(2) group compared to the control group (P < 0.001). The abdominal discomfort score at 30 minutes after CO(2) correlated with the residual gas in the small intestine (r = 0.390,P = 0.003) but not in the colon (r = 0.155, P = 0.15). The quality of the images and the number of polyps detected did not differ between two groups. CONCLUSIONS: We concluded that using CO(2) when administering a DCBE after a screening sigmoidoscopy was useful for relieving abdominal discomfort following the examination; furthermore, it did not impair the diagnostic ability of the DCBE.     

Multilocular tumors of small intestine (author's transl)]

Tumors of small intestine can be recognized in time and evaluated histologically by means of roentgenographic and endoscopical-bioptic methods, respectively. Among radiologic techniques, the double contrast examination of the small intestine has especially high diagnostic value. On the other hand, selective angiography reveals bleeding of accompanying small intestinal tumors. Out of 23 patients with these tumors -- diagnosed in the Medical Department of the Erlangen University from 1968 to July 1974 -- there was one case with multilocular occurrence; the diagnostic efficiency of double contrast technique proved to be particularly suitable in this patient.