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浙江大学学报(医学版)  2017, Vol. 46 Issue (5): 557-562    DOI: 10.3785/j.issn.1008-9292.2017.10.17
原著     
双气囊小肠镜和多层螺旋CT对小肠肿瘤的诊断价值
叶红柔1,2, 陈春晓1
1. 浙江大学医学院附属第一医院消化内科, 浙江 杭州 310003;
2. 温岭市中医院消化内科, 浙江 温岭 317500
Comparison of double-balloon endoscopy and multi-detector row computed tomography in diagnosis of small intestinal tumors
YE Hongrou1,2, CHEN Chunxiao1
1. Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
2. Department of Gastroenterology, Wenling Traditional Chinese Medical Hospital, Wenling 317500, Zhejiang Province, China
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摘要:

目的:评估双气囊小肠镜(DBE)和多层螺旋CT (MDCT)在小肠肿瘤诊断中的价值。方法:回顾性分析2010年1月至2016年12月在浙江大学医学院附属第一医院住院治疗的88例经病理学检查确诊为小肠肿瘤患者的临床资料,评估DBE和MDCT在小肠肿瘤诊断中的价值。结果:DBE对小肠肿瘤的检出率为92.0%(81/88),MDCT对小肠肿瘤的检出率为75.0%(66/88),差异有统计学意义(P<0.01)。DBE和MDCT对小肠恶性肿瘤的检出率均为91.1%(51/57),但DBE检查的定性准确率高于MDCT (94.1%与76.5%,χ2=6.331,P<0.05);DBE和MDCT对小肠良性肿瘤的检出率分别为96.8%(30/31)和48.4%(15/31),差异有统计学意义(χ2=18.235,P<0.01)。对于以消化道出血为主要表现的小肠肿瘤,DBE较MDCT有更高的检出率(97.2%与77.8%,χ2=6.222,P<0.05)。对于直径小于3 cm的肿瘤,DBE较MDCT有更高的检出率(88.2%与47.1%,χ2=13.170,P<0.01)。结论:DBE对小肠肿瘤的诊断价值高于MDCT,两者联用可以提高小肠肿瘤诊断的准确性。

关键词: 内窥镜检查肠肿瘤/放射摄影术肠肿瘤/诊断体层摄影术螺旋计算机对比研究    
Abstract:

Objective: To compare the diagnostic value of double-balloon endoscopy (DBE) and multi-detector row computed tomography (MDCT) for small intestinal tumors.Methods: The clinical data of 88 patients with small intestinal tumor who underwent DBE and MDCT examinations during January 2010 and December 2016 was retrospectively analyzed. The diagnostic value of DBE and MDCT for small intestinal tumor was compared.Results: The positive rate of small intestinal tumors by DBE (92.0%, 81/88) was significantly higher than that of MDCT (75.0%, 66/88, P<0.01). The positive rates for malignant small intestinal tumors by DBE and MDCT were the same (91.1%), but the rate of histological qualitation was higher in DBE than that in MDCT (94.1% vs 76.5%, χ2=6.331, P<0.05); the positive rates for benign tumors or the tumors <3 cm in diameter by DBE were significantly higher than those by MDCT (96.8% vs 48.4%, 88.2% vs 47.1%, respectively, χ2=18.235 and 13.170, both P<0.01); also DBE had a higher positive rate for small intestinal tumor presenting gastrointestinal bleeding (97.2% vs 77.8%, χ2=6.222, P<0.05). Conclusions: The diagnostic value of small intestinal tumor by DBE is significantly higher than that of MDCT. The combination of two methods may improve the diagnostic accuracy for small intestinal tumor.

Key words: Intestinal neoplasms/diagnosis    Intestinal neoplasms/radiography    Comp study    Endoscopy    Tomography,spiral computed
收稿日期: 2017-04-21 出版日期: 2017-10-25
CLC:  R814.42  
通讯作者: 陈春晓(1963-),女,硕士,主任医师,硕士生导师,主要从事炎症性肠病研究;E-mail:13906523922@126.com;http://orcid.org/0000-0001-7536-1191     E-mail: 13906523922@126.com
作者简介: 叶红柔(1987-),女,硕士研究生,主治医师,主要从事小肠疾病研究;E-mail:yehongrou@126.com;http://orcid.org/0000-0002-9730-6262
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引用本文:

叶红柔 等. 双气囊小肠镜和多层螺旋CT对小肠肿瘤的诊断价值[J]. 浙江大学学报(医学版), 2017, 46(5): 557-562.

YE Hongrou, CHEN Chunxiao. Comparison of double-balloon endoscopy and multi-detector row computed tomography in diagnosis of small intestinal tumors. Journal of ZheJiang University(Medical Science), 2017, 46(5): 557-562.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2017.10.17        http://www.zjujournals.com/xueshu/med/CN/Y2017/V46/I5/557

[1] SIEGEL R L, MILLER K D, JEMAL A. Cancer statistics, 2017[J]. CA Cancer J Clin,2017,67(1):7-30.
[2] BILIMORIA K Y, BENTREM D J, WAYNE J D, et al. Small bowel cancer in the United States:changes in epidemiology, treatment, and survival over the last 20 years[J]. Ann Surg,2009,249(1):63-71.
[3] ELL C, REMKE S, MAY A, et al. The first prospective controlled trial comparing wireless capsule endoscopy with push enteroscopy in chronic gastrointestinal bleeding[J]. Endoscopy,2002,34(9):685-689.
[4] 陈英东.多层螺旋CT诊断小肠肿瘤的临床研究[J].中国肿瘤临床与康复,2013,20(5):484-486. CHEN Yingdong. Clinical application of muti-slice CT in the diagnosis of small intestinal tumors[J]. Chinese Journal of Clinical Oncology and Rehabilitation,2013,20(5):484-486.(in Chinese)
[5] MITSUI K, TANAKA S, YAMAMOTO H, et al. Role of double-balloon endoscopy in the diagnosis of small-bowel tumors:the first Japanese multicenter study[J]. Gastrointest Endosc,2009,70(3):498-504.
[6] 钟捷.小肠肿瘤临床特征及双气囊电子内镜的应用价值[J].中国实用外科杂志,2008,28(11):937-939. ZHONG Jie. Clinical features of small intestinal tumors and the application value of Double-balloon endoscopy[J]. Chinese Journal of Practical Surgery,2008,28(11):937-939. (in Chinese)
[7] LEE B I, CHOI H, CHOI K Y, et al. Clinical characteristics of small bowel tumors diagnosed by double-balloon endoscopy:KASID multi-center study[J]. Dig Dis Sci,2011,56(10):2920-2927.
[8] CHEN W G, SHAN G D, ZHANG H, et al. Double-balloon enteroscopy in small bowel tumors:a Chinese single-center study[J]. World J Gastroenterol,2013,19(23):3665-3671.
[9] 张拥军,王念林,彭伯坚,等.原发性小肠肿瘤91例临床病理分析[J].中华实用诊断与治疗杂志,2009,23(10):1023-1024. ZHANG Yongjun, WANG Nianlin, PENG Bojian, et al. Clinicopathological analysis of primary small intestinal neoplasms in 91 cases[J]. Journal of Chinese Practical Diagnosis and Therapy,2009,23(10):1023-1024. (in Chinese)
[10] CHEN W G, SHAN G D, ZHANG H,et al. Double-balloon enteroscopy in small bowel diseases:eight years single-center experience in China[J/OL]. Medicine (Baltimore),2016,95(42):e5104.
[11] SHI H, REN J, DONG W. Double-balloon enteroscopy in the diagnosis and management of small-bowel diseases[J]. Hepatogastroenterology,2011,58(106):477-486.
[12] HONDA W, OHMIYA N, HIROOKA Y, et al. Enteroscopic and radiologic diagnoses, treatment, and prognoses of small-bowel tumors[J]. Gastrointest Endosc,2012,76(2):344-354.
[13] ONAL I K, AKDOGAN M, ARHAN M, et al. Double balloon enteroscopy:a 3-year experience at a tertiary care center[J]. Hepatogastroenterology,2012,59(118):1851-1854.
[14] XIN L, LIAO Z, JIANG Y P, et al. Indications, detectability, positive findings, total enteroscopy, and complications of diagnostic double-balloon endoscopy:a systematic review of data over the first decade of use[J]. Gastrointest Endosc,2011,74(3):563-570.
[15] ODAGIRI H, MATSUI H, FUSHIMI K, et al. Factors associated with perforation related to diagnostic balloon-assisted enteroscopy:analysis of a national inpatient database in Japan[J]. Endoscopy,2015,47(2):143-146.
[16] BOUDIAF M, JAFF A, SOYER P, et al. Small-bowel diseases:prospective evaluation of multi-detector row helical CT enteroclysis in 107 consecutive patients[J]. Radiology,2004,233(2):338-344.
[17] SHINYA T, INAI R, TANAKA T, et al. Small bowel neoplasms:enhancement patterns and differentiation using post-contrast multiphasic multidetector CT[J]. Abdom Radiol (NY),2017,42(3):794-801.
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