摘要
目的：评价 CT 小肠成像（CTE）与胶囊内镜（CE）在诊断小肠疾病时，对不同适应证患者诊断的优劣。方法收集近3年间于消化内科因疑诊为小肠疾病行 CTE 及 CE 检查，且检查时间间隔＜2周的住院患者资料，比较2种检查方法发现小肠病变的阳性率、小肠病变的病变性质及病变部位的特点，以及两者联合诊断小肠疾病对诊断正确率的影响。结果最终47例患者纳入研究，检查适应证包括：疑诊或确诊克罗恩病（CD）（28例）、不明原因腹痛（14例）、不明原因消化道出血（OGIB）（3例）、不全性肠梗阻（1例）、蛋白丢失性肠病（1例）。2种检查对全小肠病变的诊断阳性率差异无统计学意义（CE 83.0％比 CTE 78.7％，P ＝0.791）。针对疑诊或确诊 CD 患者，两者诊断正确率差异有统计学意义（CTE 35.7％比 CE 78.6％，P ＝0.002），且 CE 能较 CTE 发现更多的空肠病变（CE 50.0％比 CTE 7.1％，P ＝0.002）；联合 2种检查，可使诊断正确率提高至100.0％。针对不明原因腹痛的患者，两者诊断正确率差异无统计学意义（CTE 42.8％比 CE 50.0％，P ＝1.000）。联合 2种检查，可使诊断正确率提高至85.7％。结论CTE 及 CE 均能有效发现小肠病变，但针对确诊或疑诊 CD 患者，CE 的诊断能力要优于 CTE。而针对不明原因腹痛的患者，往往需要联合应用才能做出更正确的诊断。
Objective To compare the role of CTE and CE on the diagnosis of small bowel diseases and evaluate their advantages in patients with different indications.Methods Patients underwent both CTE and CE（interval time 〈2 weeks）at our institution in recent 3 years were enrolled.The positive detection rates,lesion properties and characteristics of CTE and CE were compared.The diagnostic accuracy of combined method was also analyzed.Results A total of 47 patients were enrolled and the indications included suspected or established Crohn′s disease （28 cases）,unexplained abdominal pain （14 cases）, obscure gastrointestinal bleeding（3 cases）,insufficient small bowel obstruction（1 case）and protein losing enteropathy（1 case）.Diagnostic yield of CTE and CE for whole small bowel disorders showed no significant difference（CE 83.0% VS CTE 78.7%,P =0.791）.For suspected or established CD,CE had a higher diagnostic accuracy than CTE （78.6% VS 35.7%,P =0.002 ）,especially in detecting lesions in the jejunum（CE 50.0% VS CTE 7.1%,P =0.002）.The diagnostic accuracy reached 100.0% when two meth-ods were combined.For unexplained abdominal pain,no significant difference was found in the diagnostic ac-curacy of CE and CTE（CTE 42.8% VS CE 50.0%,P =1.000）.Diagnostic accuracy of combining CTE and CE was 85.7%.Conclusion CTE and CE are both valuable in detecting small bowel lesions.For pa-tients with suspected or established CD,CE is better than CTE.For patients with unexplained abdominal pain,a combination of CTE and CE may be a better strategy than use CTE or CE alone.
出处
《中华消化内镜杂志》
北大核心
2015年第3期140-144,共5页
Chinese Journal of Digestive Endoscopy
关键词
胶囊内窥镜
小肠
CT
小肠成像
Capsule endoscopes
Small bowel
CT enterology
