摘要
目的探讨CT仿真结肠镜(CTVC)在结直肠疾病,尤其是溃疡性结肠炎诊断中的价值。方法应用螺旋CT对2004年5月至2005年1月就诊于首都医科大学附属北京友谊医院的58例疑诊结直肠病变患者进行容积扫描,获取仿真结肠镜图像,将所得结果与结肠镜结果进行比较分析。结果CTVC检查均获得成功,共检出结直肠癌14例,结直肠息肉15例,溃疡性结肠炎14例,正常者6例。CTVC对结直肠疾病总的敏感性为82.7%(43/52),特异性为100%,准确性为84.5%(49/58),阳性预测值87.8%(43/49),阴性预测值40.0%(6/15),Kappa值为0.497;CTVC对溃疡性结肠炎诊断的敏感性为70.0%(14/20),特异性为100%,准确性为76.9%(20/26),阳性预测值70.0%(14/20),阴性预测值50.0%(6/12),Kappa值为0.519。结论CTVC是一种无创的检查方法,具有一定优势,但仍存在一些弊端,因此对于溃疡性结肠炎诊断仅是一种有效的补充,尚不能完全替代常规结肠镜检查。
Objective To determine the Sensitivity, specificity, and diagnostic accuracy of CT virtual colonoscopy （CTVC） compared with conventional colonoscopy （CC） in colorectal diseases. Methods Fifty-eight patients underwent conventional colonography followed immediately by CTVC images were obtained using a volume analysis software in workstation. Statistical analysis was done using X^2 test comparing two groups. Results CTVC displayed colon morphology in a manner similar to conventional colonoscopy. 14 cases of colorectal carcinoma, 15 cases of colorectal polyps, 14 cases of ul- cerative colitis,6 cases of normal were detected by CTVC. The sensitivity of CTVC was 82. 7%, specificity 100%, diagnostic accuracy 84. 5% ,positive predictive value 87. 8% ,negative predictive value 40. 0%. The Kappa is 0. 497. In ulcerative colitis,the sensitivity of CTVC was 70. 0%, specificity 100%, diagnostic accuracy 76. 9%, positive predictive value 70. 0%, negative predictive value 50. 0%, and the Kappa is 0. 519. Conclusion CTVC is a safe, noninvasive method for colorectal diseases, especially for colorectal carcinoma and colorectal polyps, but a complementary technique for examining ulcerative colitis can not replace CC in diagnosis of colorectal carcinoma.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2007年第13期1047-1048,共2页
Chinese Journal of Practical Internal Medicine
关键词
CT仿真结肠镜
结直肠疾病
溃疡性结肠炎
Computed tomographic virtual colonoscopy （CTVC）
Colorectal diseases
Ulcerative colitis
