CT结肠镜在结肠息肉诊断中的应用

目的评价CT结肠镜(CTC)用于结肠息肉诊断的临床价值。方法采用多排螺旋CT(16/64)扫描及专业图像处理技术,以结肠镜检查为金标准,回顾性分析了42例行CTC并结肠镜检查的临床怀疑结肠息肉或要求行结肠疾病筛查患者的临床资料。依据诊断性试验统计学方法,分为息肉组和患者组,其中息肉组再按直径分为≤5mm、5～10mm和≥10mm3组,统计CTC对全部息肉检出的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)和准确度。结果CTC与结肠镜诊断息肉数分别为90和61。息肉组总体敏感度及PPV分别为80.3%和55.6%,其中,≤5mm、5～10mm和≥10mm3组分别为68.8%/41.5%、93.8%/65.2%和100%/92.9%。患者组的敏感度、PPV、特异度、NPV及准确度分别为97.1%、89.5%、42.9%、75.0%和88.1%。结论CTC图像能清晰显示出息肉形态,可作为临床息肉筛选的常规方法。

Application of CT colonography in diagnosis of colonic polyps

OBJECTIVE: To assess the clinical values of CT colonography (CTC) in the diagnosis of colonic polyps. METHODS: Forty-two patients who were clinically suspicious of colonic polyps or underwent colonic polyps screening received both CTC and conventional colonoscopy. Sixteen or 64-slice spiral CT and professional imaging processing techniques were used for evaluation. Per-polyp and per-patient results were analyzed. Those by per-polyp were subsequently divided into > or = 10 mm group, 5-10 mm group, and < or = 5 mm group. Sensitivity, positive predictive value (PPV), specificity, negative predictive value (NPV), and accuracy were calculated using statistical method for diagnostic studies, with conventional colonoscopy as a gold standard. RESULTS: Ninety and 61 polyps were found by CTC and conventional colonoscopy, respectively. Sensitivity and PPV were 80.3%/55.6% by per-polyp and 100%/92.9%, 93.8%/65.2%, and 68.8%/ 41.5% in the > or = 10 mm group, 5-10 mm group, and < or = 5 mm group, respectively. Sensitivity, PPV, specificity, NPV, and accuracy by per-patient were 97.1%, 89.5%, 42.9%, 75.0%, and 88.1%, respectively. CONCLUSION: CTC can clearly reveal the morphology of colonic polyps and can be used as a routine monitoring method for the clinical diagnosis of polyps.