仿真CT肠镜与大肠镜在小儿外科的应用

目的 对仿真CT肠镜与大肠镜在小儿外科的应用进行比较。方法 对33例患儿采用日本Olympus PCF20大肠镜及美国GE公司Hispead型螺旋CT仿真大肠镜进行检查。大肠镜检查使用Endoview软件记录内镜图像，完毕后再进行CT检查，使用Insight软件进行CT三维图像重建，利用Modify Endoscopy程序显示肠腔内的形态结构。结果 本组33例患儿，仿真CT肠镜（CTVE）检出肠重复畸形2例，肠旋转不良3例，结肠冗长症5例，大肠息肉10例（漏诊5例），溃疡性结肠炎、大肠血管畸形未能检出；大肠镜检出肠放置不良2例（漏诊1例），结肠冗长症5例，大肠息肉15例，溃疡性结肠炎6例，大肠血管畸形2例，肠重复畸形未能检出。仿真CT肠镜对诊断肠道畸形具有较高的准确性，但对于直径小于0.5cm的大肠息肉、肠血管畸形检出率低，易漏诊；对小儿溃疡性结肠炎的粘膜显示不理想。大肠镜则对于诊断大肠息肉、溃疡性结肠炎、大肠血管畸形有较高的准确性。结论 仿真CT肠镜是诊断肠道畸形的一种有效途径，但是对肠道粘膜的病变的显示不理想；是大肠镜检的一种重要补充手段。

Application of computed tomography virtual endoscopy and colonoscopy in pediatric surgery

Objective To compare the application of computerised tomography virtual endoscopy (CTVE) with colonoscopy in pediatric surgery.Methods Spiral CT and colonoscopy were performed on 33 children.The image form colonoscopy was recorded by the Endoview program.3 dimensional image was generated from the CT data,using insight and modify endoscopy programs.Results Of them,the diagnosis was enteric duplications in 2,intestinal malrotation in 3,redundant colon in 5,colonic polyps in 10 ( missed diagnosis in 5/10).Cases with ulcerative colitis and vascular abnormality were not diagnosed correctly.Conclusions CTVE is more accurate than colonoscopy in diagnosing congenital intestinal abnormality,but it is less sensitive in detecting mucosal lesions,intestinal polyps less than 5mm in diameter,vascular abnormality and ulcerative colitis.It can be used as a complementary technique to colonoscopy in the pediatric surgical practice.