中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2009年
1期
21-24
,共4页
许永华%蔡文立%Nappi J%Yoshida H
許永華%蔡文立%Nappi J%Yoshida H
허영화%채문립%Nappi J%Yoshida H
结肠疾病%盲肠疾病%结肠镜检查,计算机体层摄影
結腸疾病%盲腸疾病%結腸鏡檢查,計算機體層攝影
결장질병%맹장질병%결장경검사,계산궤체층섭영
Colonic diseases%Cecal diseases%Colonography,computed tomographic
目的 评价结构分析电子清肠软件应用于粪便标记三维X线断层结肠成像术(SAEC-3D CTC)检测结直肠平坦型病变的可行性和检出敏感度,并与Viatronix三维CT结肠成像(V3D CTC)和无电子清肠的二维CT结肠成像(2D CTC)比较.方法 40例经CT结肠成像(CTC)检查的患者发现69个结直肠平坦型病变.结肠镜检查证实后,将这些病例分别独立进行SAEC-3D、V3D和2D CTC研究分析其检出敏感度.以结肠镜观察为金标准,结直肠平坦型病变定义为病变高度≤2 mm或小于其宽度的1/2.结果 69个结直肠平坦型病变中,直径2～3 mm 27个、4～6 mm 28个、7～9 mm 11个、≥10 mm 3个.SAEC-3D CTC的结直肠平坦型病变检出敏感度为51%(35/69),明显高于V3D CTC的32%(22/69)和2D CTC的29%(20/69)(P<0.05);SAEC-3D、V3D和2D CTC对不位于结肠黏膜皱襞的平坦型病变检出敏感度分别为61%(23/38)、45%(17/38)和42%(16/38).高于对位于结肠黏膜皱襞内的平坦型病变检出敏感度的39%(12/31)、16%(5/31)和13%(4/31).这三种CTC方法均未检出所有8个位于盲肠的病变(直径2～9 mm).除盲肠病变外,SAEC-3D CTC对直径≥4 mm平坦型病变的检出敏感度达84%(31/3F).结论 结构分析电子清肠软件应用于粪便造影剂标记3D CTC检测直径≥4 mm结直肠平坦型病变可达到较高的敏感度;而且对不位于结肠黏膜皱襞的病变检出敏感度高于位于结肠黏膜皱襞的病变.盲肠平坦型病变町能是CTC的盲区.
目的 評價結構分析電子清腸軟件應用于糞便標記三維X線斷層結腸成像術(SAEC-3D CTC)檢測結直腸平坦型病變的可行性和檢齣敏感度,併與Viatronix三維CT結腸成像(V3D CTC)和無電子清腸的二維CT結腸成像(2D CTC)比較.方法 40例經CT結腸成像(CTC)檢查的患者髮現69箇結直腸平坦型病變.結腸鏡檢查證實後,將這些病例分彆獨立進行SAEC-3D、V3D和2D CTC研究分析其檢齣敏感度.以結腸鏡觀察為金標準,結直腸平坦型病變定義為病變高度≤2 mm或小于其寬度的1/2.結果 69箇結直腸平坦型病變中,直徑2～3 mm 27箇、4～6 mm 28箇、7～9 mm 11箇、≥10 mm 3箇.SAEC-3D CTC的結直腸平坦型病變檢齣敏感度為51%(35/69),明顯高于V3D CTC的32%(22/69)和2D CTC的29%(20/69)(P<0.05);SAEC-3D、V3D和2D CTC對不位于結腸黏膜皺襞的平坦型病變檢齣敏感度分彆為61%(23/38)、45%(17/38)和42%(16/38).高于對位于結腸黏膜皺襞內的平坦型病變檢齣敏感度的39%(12/31)、16%(5/31)和13%(4/31).這三種CTC方法均未檢齣所有8箇位于盲腸的病變(直徑2～9 mm).除盲腸病變外,SAEC-3D CTC對直徑≥4 mm平坦型病變的檢齣敏感度達84%(31/3F).結論 結構分析電子清腸軟件應用于糞便造影劑標記3D CTC檢測直徑≥4 mm結直腸平坦型病變可達到較高的敏感度;而且對不位于結腸黏膜皺襞的病變檢齣敏感度高于位于結腸黏膜皺襞的病變.盲腸平坦型病變町能是CTC的盲區.
목적 평개결구분석전자청장연건응용우분편표기삼유X선단층결장성상술(SAEC-3D CTC)검측결직장평탄형병변적가행성화검출민감도,병여Viatronix삼유CT결장성상(V3D CTC)화무전자청장적이유CT결장성상(2D CTC)비교.방법 40례경CT결장성상(CTC)검사적환자발현69개결직장평탄형병변.결장경검사증실후,장저사병례분별독립진행SAEC-3D、V3D화2D CTC연구분석기검출민감도.이결장경관찰위금표준,결직장평탄형병변정의위병변고도≤2 mm혹소우기관도적1/2.결과 69개결직장평탄형병변중,직경2～3 mm 27개、4～6 mm 28개、7～9 mm 11개、≥10 mm 3개.SAEC-3D CTC적결직장평탄형병변검출민감도위51%(35/69),명현고우V3D CTC적32%(22/69)화2D CTC적29%(20/69)(P<0.05);SAEC-3D、V3D화2D CTC대불위우결장점막추벽적평탄형병변검출민감도분별위61%(23/38)、45%(17/38)화42%(16/38).고우대위우결장점막추벽내적평탄형병변검출민감도적39%(12/31)、16%(5/31)화13%(4/31).저삼충CTC방법균미검출소유8개위우맹장적병변(직경2～9 mm).제맹장병변외,SAEC-3D CTC대직경≥4 mm평탄형병변적검출민감도체84%(31/3F).결론 결구분석전자청장연건응용우분편조영제표기3D CTC검측직경≥4 mm결직장평탄형병변가체도교고적민감도;이차대불위우결장점막추벽적병변검출민감도고우위우결장점막추벽적병변.맹장평탄형병변정능시CTC적맹구.
Objective To evaluate the feasibility and sensitivity of the 3D-reading of fecal-tagging computed tomographic colonography0 (CTC) with a novel structure-analysis electronic cleansing (SAEC) in detecting colorectal flat lesions in comparison with a prospective 3D reading with Viatronix colon system (V3D) and 2D reading without electronic cleansing (2D). Methods Forty CTC cases with flat lesions were retrospectively observed. The subjects from a muhicenter clinical trial underwent cathartic bowel preparation with orally administrated barium-based fecal tagging. Sixty-nine flat lesions were confirmed using colonoscopy and histopathology as a reference standard. The results from SAEC reading were compared with those of prospective V3D and 2D readings. Results Overall detection sensitivity with SAEC was 51% (35/69), which was statistically higher than that of 32% (22/69) and 29% (20/69) with V3D and 2D readings, respectively (P<0.05). The sensitivities in detecting not-on-fold flat lesions were 61% (23/38), 45% ( 17/38), and 42% (16/38) with SAEC, V3D, and 2D readings, respectively; whereas those of on-fold flat lesions were 39% (12/31), 16% (5/31), and 13% (4/31), respectively. None of the eight fiat lesions (2-9 mm) at cecum was detected by any of the three reading methods. Excluding the flat lesions at cecum, the sensitivity with SAEC for detecting flat lesion ≥ 4 mm increased to 84% (31/37). Conclusions The fecal-tagging CTC with structure-analysis electronic cleansing could yield a high sensitivity for detecting flat lesions ≥ 4 mm. The not-on-fold flat lesions were detected with higher sensitivity than on-fold flat lesions. Cecum may be a blind segment in the detection of flat lesions.
