口服2.5％等渗甘露醇作为肠道对比剂在腹部CT扫描中的应用研究

目的 探讨口服2.5％等渗甘露醇作为肠道对比剂在腹部CT扫描中的应用价值.方法 将行腹部CT检查的患者300例,根据口服不同对比剂分成甘露醇组、泛影葡胺组和蒸馏水组三组,每组各100例.分别于检查前分3次口服总量为l 400 ml的2.5％等渗甘露醇、2％泛影葡胺和蒸馏水.比较分析各组患者肠道充盈情况及CT检查的敏感性、特异性、阳性预测值及阴性预测值.结果 甘露醇组肠道的充盈状态显著优于泛影葡胺组和蒸馏水组（P＜0.05）;泛影葡胺组肠腔对比剂密度、肠壁密度显著高于甘露醇组、蒸馏水组（P＜0.05）;甘露醇组对小肠病变诊断的敏感性、特异性、阳性预测值及阴性预测值均高于泛影葡胺组、蒸馏水组.结论 2.5％等渗甘露醇在腹部CT检查中可有效减少伪影干扰,更好充盈肠管,提高胃肠道疾病的检出率及诊断准确率,是腹部CT扫描中一种理想的肠道对比剂.

Application of oral administration of 2.5% isotonic mannitol as contrast agents for small intestine in abdominal CT scan

Objective To explore the value of oral administration of 2.5% isotonic mannitol as contrast agents for small intestine in abdominal CT enterography. Methods According to different oral contrast agents, 300 patients who received abdominal CT examination were divided into three groups： mannitol group, diatrizoate meglu- mine group, and water group, with 100 patients in each group. The patients took 1 400 ml 2.5% isotonic mannitol with- in three times before examination, as well as 2% diatrizoate meglumine and water. The degree of gastrointestinal fill- ing and diagnostic sensitivity, specificity, positive prediction rate and negative prediction rate by CT were compared among the groups. Results The degree of gastrointestinal filling in mannitol group was significantly better than that in diatrizoate meglumine group and water group （P〈0.05）. The enteric cavity density of contrast agents and in- testinal wall in diatrizoate meglumine group were significantly higher than that in mannitol group and water group （P〈0.05）. The diagnostic sensitivity, specificity, positive prediction rate and negative prediction rate in mannitol group for prognosis of small intestine disease were all higher than those in diatrizoate meglumine group and water group. Conclusion In abdominal CT examination, 2.5% isotonic marmitol can effectively reduce the artifact interfer- ence, better filling intestinal canal, and improve the diagnostic accuracy rate and detection rate of gastrointestinal tract disease, which could be served as an ideal intestinal contrast agent of abdominal CT.