口服法小肠灌肠CT检查的诊断价值研究

目的：评价口服法小肠灌肠CT检查对小肠病变的诊断价值。材料和方法：研究的对象包括2003年1月-2005年3月间53例临床怀疑有小肠病变而行小肠CT检查的患者。扫描前20—30rain口服混合溶液（每1000ml由20％甘露醇250ml＋5％糖盐水500ml＋水250ml所配成）约2000ml充盈小肠。首先，对小肠的扩张程度进行评价；其次，通过横断位及多平面重建，从局限性或弥漫性肠壁增厚、小肠肿块、小肠系膜扭转、肠系膜淋巴结肿大、远处转移几方面进行征象分析，并作出诊断。分别计算小肠CT检查的敏感度、特异度、阳性预测值和阴性预测值。结果：小肠扩张最佳的24例（24／53），扩张良好的25例（25／53），扩张欠佳的4例（4／53），无扩张0例（0／53）；口服肠道准备小肠CT检查的敏感度为97．6％（40／41），特异度为75％（9／12），阳性预测值为93．0％（40／43），阴性预测值为90．0％（9／10）。结论：口服肠道准备小肠螺旋CT检查方能够很好满足诊断需要，对小肠病变具有诊断价值。

Small - bowel Diseases: Evaluation of Multi - detector Helical CT with Oral Contrast

Purpose:To prospectively evaluate multi-detector helical computed tomographic (CT) with oral contrast for the depiction of small-bowel diseases.Materials and Methods:The study group included 53 patients who were suspected of small-bowel disease from January,2003 to March,2005.All patients ingested a special mixture of mannit,glucose saline and water 2000ml for distention of the small bowel before CT scan.At first,the degree of small bowel distention ,as seen on transverse CT images,was graded by means of a four-point scale.The second, transverse and multiplanar reformatted CT images were specifically analyzed for the presence of focal or diffuse bowel wall thickening, small-bowel masses, mesenteric stranding, enlarged mesenteric lymph nodes, and visceral metastasis,then, the diagnosis was made.The sensitivity, specificity, positive predictive value, and negative predictive value of multi-detector helical CT were calculated.Results:The degree of small-bowel distention varied from optimal in 24 of 53 patients, to good (a score of 2) in 25 of 53 patients, to poor (a score of 1) in 4 of 53 patients,and no one no distention. Sensitivity, specificity, positive predictive value, and negative predictive value of multi-detector helical CT with oral contrast were 97.6%, 75%, 93.0%, and 90.0%, respectively.Conclusion:Multi-detector helical CT with oral contrast allows depiction of small-bowel diseases in patients suspected with abnormal small-bowel conditions.