多层螺旋CT低剂量扫描对小肠原发性肿瘤的定位诊断意义
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摘要
目的:探讨多层螺旋CT(multi-slice spiral CT,MSCT)低剂量扫描对小肠原发性肿瘤的定位诊断意义。方法:采用回顾性研究方法,2015年2月到2017年12月选择在我院诊治的经手术或临床证实的小肠原发性肿瘤患者45例作为研究对象,所有患者都给予MSCT低剂量扫描,记录定位诊断效果与诊断价值。结果:在45例患者中,MSCT低剂量扫描鉴别诊断为小肠癌15例,良性肿瘤30例,其中间质瘤22例,脂肪瘤8例;其对小肠原发性肿瘤的诊断敏感性与特异性为100.0%和96.8%。病变肠壁和正常肠壁的k值对比差异有统计学意义(P<0.05);当取k值为2.00时,其鉴别诊断小肠原发性肿瘤的敏感性、特异性与AUC值分别为0.956、0.914和0.964。结论:MSCT低剂量扫描在小肠原发性肿瘤的应用可明确病变空间形态与周围组织的毗邻关系,有利于进行定位诊断,诊断敏感性与特异性好,有很好的应用价值。
Objective:To investigate the location diagnostic significance of low-dose multi-slice spiral CT(MSCT)for small intestinal primary tumor.Methods:With a retrospective summary of research methods,from February 2015 to December 2017,45 patients with small intestinal primary tumor in our hospital confirmed by surgery or clinical primary were selected as the research object.All patients were given MSCT low dose scan,and the location and diagnosis values were recorded.Results:In the 45 patients,the MSCT low dose scan showed 15 cases of small intestinal cancer,30 cases of benign tumors that included 22 cases of stromal tumor,8 cases of lipoma.The primary small intestinal tumor diagnostic sensitivity and specificity were 100.0% and 96.8%.There was significant difference between the k value of the intestinal wall and the normal intestinal wall(P<0.05).When the k value was 2,the sensitivity,specificity and AUC of the differential diagnosis of primary tumors of the small intestine were 0.956,0.914 and 0.964,respectively.Conclusion:The application of MSCT low dose scan in primary tumors of small intestine can confirm the adjacent relationship between the spatial form and the surrounding tissues,which is helpful for location diagnosis,and it has better diagnosis sensitivity and specificity,and so has good application values.
Objective:To investigate the location diagnostic significance of low-dose multi-slice spiral CT(MSCT)for small intestinal primary tumor.Methods:With a retrospective summary of research methods,from February 2015 to December 2017,45 patients with small intestinal primary tumor in our hospital confirmed by surgery or clinical primary were selected as the research object.All patients were given MSCT low dose scan,and the location and diagnosis values were recorded.Results:In the 45 patients,the MSCT low dose scan showed 15 cases of small intestinal cancer,30 cases of benign tumors that included 22 cases of stromal tumor,8 cases of lipoma.The primary small intestinal tumor diagnostic sensitivity and specificity were 100.0% and 96.8%.There was significant difference between the k value of the intestinal wall and the normal intestinal wall(P<0.05).When the k value was 2,the sensitivity,specificity and AUC of the differential diagnosis of primary tumors of the small intestine were 0.956,0.914 and 0.964,respectively.Conclusion:The application of MSCT low dose scan in primary tumors of small intestine can confirm the adjacent relationship between the spatial form and the surrounding tissues,which is helpful for location diagnosis,and it has better diagnosis sensitivity and specificity,and so has good application values.
引文
[1] Jun L,ChangYi S.Diagnostic value of plain and contrast radiography,and multi-slice computed tomography in diagnosing intestinal obstruction in different locations[J].Indian J Surg,2015,77(Suppl 3):1248-1251.
[2] Wang J,Li H,Liu Y,et al.Application of virtual unenhanced imaging of dual-source CT in small intestine lesions[J].Journal of China Clinic Medical Imaging,2017,28(4):260-263.[王俊,李辉,刘焱,等.双源CT虚拟平扫在小肠病变中的应用[J].中国临床医学影像杂志,2017,28(4):260-263.]
[3] Lisitskaia MV,Sinitsyn VE.Role of multislice computed tomography in the differential diagnosis of right iliac tumors and inflammatory diseases[J].Vestn Rentgenol Radiol,2015,12(2):35-41.
[4] Zuo KH,He L,Chou JH.Diagnostic value of MSCTE signs of intestinal wall thickening in different types of small bowel diseases[J].Modern Digestion & Intervention,2017,22(3):370-372.[左开华,何林,仇俊华.小肠肠壁增厚的MSCTE征象在不同类型小肠疾病诊断中的价值[J].现代消化及介入诊疗,2017,22(3):370-372.]
[5] Guo WL,Bai XJ,Huang SG,et al.The role of 64-slice CT following perfusion with iohexol via the hepatopancreatic ampulla in assessing pancreaticobiliary junctions[J].Clin Anat,2015,28(5):645-648.
[6] Zhao ZX,Guan X,Chen YG,et al.Progression of diagnosis and treatment in primary malignant small bowel tumor[J].Chinese Journal of Gastrointestinal Surgery,2017,20(1):117-120.[赵志勋,关旭,陈瑛罡,等.原发性小肠恶性肿瘤诊疗进展[J].中华胃肠外科杂志,2017,20(1):117-120.]
[7] He B,Gong S,Hu C,et al.Obscure gastrointestinal bleeding:Diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy[J].Br J Radiol,2014,87(1043):20140229.
[8] Chen S,Chen YX,Shu X,et al.A clinical analysis of 207 cases of small intestinal bleeding[J].Acta Academiae Medicinae Jiangxi(Medical Edition),2017,57(1):63-65.[陈硕,陈幼祥,舒徐,等.小肠出血207例临床分析[J].南昌大学学报(医学版),2017,57(1):63-65.]
[9] Iwamoto C,Ohuchida K,Okumura M,et al.Postmortem interval estimation using the animal model of postmortem gas volume changes[J].Leg Med (Tokyo),2017,20(32):66-70.
[10] Han X,Zhang WS,Sun MY.Application value of ct and mri in diagnosis of Ewing's sarcoma/primitive neuroectodermal tumor:A case report and literature review[J].China Medical Devices,2017,32(5):80-83.[韩旭,张挽时,孙美玉.CT及MRI在诊断小肠原发尤文肉瘤/原始神经外胚层肿瘤中的价值一例并文献回顾[J].中国医疗设备,2017,32(5):80-83.]
[11] Fujikawa H,Kuwai T,Yamaguchi T,et al.Gastric and enteric anisakiasis successfully treated with Gastrografin therapy:A case report[J].World J Gastrointest Endosc,2018,10(3):69-73.
[12] Yang H,Yang Y,Li DC,et al.The value of 64-MDCT diagnosis of intestinal tumor[J].Computerized Tomography Theory and Applications,2017,26(2):241-246.[杨红,杨莹,李冬成,等.64排螺旋CT扫描在肠道肿瘤术前诊断中的临床意义[J].CT理论与应用研究,2017,26(2):241-246.]
[13] Ooms H,De Schepper HU,Moreels TG.Case series of cryptogenic multifocal ulcerating stenosing enteritis (CMUSE)[J].Acta Gastroenterol Belg,2017,80(3):361-364.
[14] Huels DJ,Bruens L,Hodder MC,et al.Wnt ligands influence tumour initiation by controlling the number of intestinal stem cells[J].Nat Commun,2018,9(1):1132.
[15] Zeng ZH,Lin G,Zhao ZJ.The Analysis of CT expression for gastrointestinal stromal tumor and prediction of tumor malignant degree[J].Chinese Journal of CT and MRI,2017,15(1):101-103.[曾卓辉,林岗,赵振军.胃肠间质瘤CT表现及预测肿瘤恶性程度分析[J].中国CT和MRI杂志,2017,15(1):101-103.]
[16] Moschetta M,Virelli R,Laricchia F,et al.Lipoma of the transverse colon covered by tubulovillous adenoma:A rare indication for surgical treatment[J].G Chir,2018,39(1):63-66.
[17] Barati B,Ebrahimi F,Nazarian S.Production of chicken egg yolk antibody (IgY)against recombinant cholera toxin B subunit and evaluation of Iis prophylaxis potency in mice[J].Iran J Immunol,2018,15(1):47-58.
[18] Zhao ML,Xia ZM,Song LQ,et al.Clinical application value of abdominal ct enterography with ioversol as oral contrast in the diagnosis of small intestinal stromal tumors[J].Medicine & Philosophy,2017,38(4):60-61,64.[赵美兰,夏忠民,宋良权,等.口服碘佛醇腹部CT小肠造影在小肠间质瘤诊断中的临床应用价值[J].医学与哲学,2017,38(4):60-61,64.]
[19] Mazine K,Elbouhaddouti H,Toughrai I,et al.Volvulus of the cecum:A rare cause of intestinal occlusion:About two cases[J].Pan Afr Med J,2017,19(28):162.
[20] Poschenrieder A,Schottelius M,Osl T,et al.[(64)Cu]NOTA-pentixather enables high resolution PET imaging of CXCR4 expression in a preclinical lymphoma model[J].EJNMMI Radiopharm Chem,2017,2(1):2.
[21] Mulkerrin G,Hogan NM,Sheehan M,et al.Melena as an unusual presentation of gastrointestinal stromal tumour,a case report[J].Int J Surg Case Rep,2018,1(44):172-175.
[22] Li J,Duan YX,Tang KJ,et al.Clinical analysis of 63 cases of small bowel adenocarcinoma[J].Journal of Clinical Surgery,2017,25(7):534-536.[李杰,段艳霞,唐楷杰,等.小肠腺癌63例诊治分析[J].临床外科杂志,2017,25(7):534-536.]
[23] Gwon DI,Ko GY,Kwon YB,et al.Plug-assisted retrograde transvenous obliteration for the treatment of gastric varices:The role of intra-procedural cone-beam computed tomography[J].Korean J Radiol,2018,19(2):223-229.
[24] Motsumi MJ,Motlaleselelo P,Ayane G,et al.A case report of a giant appendiceal mucocele and literature review[J].Pan Afr Med J,2017,4(28):106.
[2] Wang J,Li H,Liu Y,et al.Application of virtual unenhanced imaging of dual-source CT in small intestine lesions[J].Journal of China Clinic Medical Imaging,2017,28(4):260-263.[王俊,李辉,刘焱,等.双源CT虚拟平扫在小肠病变中的应用[J].中国临床医学影像杂志,2017,28(4):260-263.]
[3] Lisitskaia MV,Sinitsyn VE.Role of multislice computed tomography in the differential diagnosis of right iliac tumors and inflammatory diseases[J].Vestn Rentgenol Radiol,2015,12(2):35-41.
[4] Zuo KH,He L,Chou JH.Diagnostic value of MSCTE signs of intestinal wall thickening in different types of small bowel diseases[J].Modern Digestion & Intervention,2017,22(3):370-372.[左开华,何林,仇俊华.小肠肠壁增厚的MSCTE征象在不同类型小肠疾病诊断中的价值[J].现代消化及介入诊疗,2017,22(3):370-372.]
[5] Guo WL,Bai XJ,Huang SG,et al.The role of 64-slice CT following perfusion with iohexol via the hepatopancreatic ampulla in assessing pancreaticobiliary junctions[J].Clin Anat,2015,28(5):645-648.
[6] Zhao ZX,Guan X,Chen YG,et al.Progression of diagnosis and treatment in primary malignant small bowel tumor[J].Chinese Journal of Gastrointestinal Surgery,2017,20(1):117-120.[赵志勋,关旭,陈瑛罡,等.原发性小肠恶性肿瘤诊疗进展[J].中华胃肠外科杂志,2017,20(1):117-120.]
[7] He B,Gong S,Hu C,et al.Obscure gastrointestinal bleeding:Diagnostic performance of 64-section multiphase CT enterography and CT angiography compared with capsule endoscopy[J].Br J Radiol,2014,87(1043):20140229.
[8] Chen S,Chen YX,Shu X,et al.A clinical analysis of 207 cases of small intestinal bleeding[J].Acta Academiae Medicinae Jiangxi(Medical Edition),2017,57(1):63-65.[陈硕,陈幼祥,舒徐,等.小肠出血207例临床分析[J].南昌大学学报(医学版),2017,57(1):63-65.]
[9] Iwamoto C,Ohuchida K,Okumura M,et al.Postmortem interval estimation using the animal model of postmortem gas volume changes[J].Leg Med (Tokyo),2017,20(32):66-70.
[10] Han X,Zhang WS,Sun MY.Application value of ct and mri in diagnosis of Ewing's sarcoma/primitive neuroectodermal tumor:A case report and literature review[J].China Medical Devices,2017,32(5):80-83.[韩旭,张挽时,孙美玉.CT及MRI在诊断小肠原发尤文肉瘤/原始神经外胚层肿瘤中的价值一例并文献回顾[J].中国医疗设备,2017,32(5):80-83.]
[11] Fujikawa H,Kuwai T,Yamaguchi T,et al.Gastric and enteric anisakiasis successfully treated with Gastrografin therapy:A case report[J].World J Gastrointest Endosc,2018,10(3):69-73.
[12] Yang H,Yang Y,Li DC,et al.The value of 64-MDCT diagnosis of intestinal tumor[J].Computerized Tomography Theory and Applications,2017,26(2):241-246.[杨红,杨莹,李冬成,等.64排螺旋CT扫描在肠道肿瘤术前诊断中的临床意义[J].CT理论与应用研究,2017,26(2):241-246.]
[13] Ooms H,De Schepper HU,Moreels TG.Case series of cryptogenic multifocal ulcerating stenosing enteritis (CMUSE)[J].Acta Gastroenterol Belg,2017,80(3):361-364.
[14] Huels DJ,Bruens L,Hodder MC,et al.Wnt ligands influence tumour initiation by controlling the number of intestinal stem cells[J].Nat Commun,2018,9(1):1132.
[15] Zeng ZH,Lin G,Zhao ZJ.The Analysis of CT expression for gastrointestinal stromal tumor and prediction of tumor malignant degree[J].Chinese Journal of CT and MRI,2017,15(1):101-103.[曾卓辉,林岗,赵振军.胃肠间质瘤CT表现及预测肿瘤恶性程度分析[J].中国CT和MRI杂志,2017,15(1):101-103.]
[16] Moschetta M,Virelli R,Laricchia F,et al.Lipoma of the transverse colon covered by tubulovillous adenoma:A rare indication for surgical treatment[J].G Chir,2018,39(1):63-66.
[17] Barati B,Ebrahimi F,Nazarian S.Production of chicken egg yolk antibody (IgY)against recombinant cholera toxin B subunit and evaluation of Iis prophylaxis potency in mice[J].Iran J Immunol,2018,15(1):47-58.
[18] Zhao ML,Xia ZM,Song LQ,et al.Clinical application value of abdominal ct enterography with ioversol as oral contrast in the diagnosis of small intestinal stromal tumors[J].Medicine & Philosophy,2017,38(4):60-61,64.[赵美兰,夏忠民,宋良权,等.口服碘佛醇腹部CT小肠造影在小肠间质瘤诊断中的临床应用价值[J].医学与哲学,2017,38(4):60-61,64.]
[19] Mazine K,Elbouhaddouti H,Toughrai I,et al.Volvulus of the cecum:A rare cause of intestinal occlusion:About two cases[J].Pan Afr Med J,2017,19(28):162.
[20] Poschenrieder A,Schottelius M,Osl T,et al.[(64)Cu]NOTA-pentixather enables high resolution PET imaging of CXCR4 expression in a preclinical lymphoma model[J].EJNMMI Radiopharm Chem,2017,2(1):2.
[21] Mulkerrin G,Hogan NM,Sheehan M,et al.Melena as an unusual presentation of gastrointestinal stromal tumour,a case report[J].Int J Surg Case Rep,2018,1(44):172-175.
[22] Li J,Duan YX,Tang KJ,et al.Clinical analysis of 63 cases of small bowel adenocarcinoma[J].Journal of Clinical Surgery,2017,25(7):534-536.[李杰,段艳霞,唐楷杰,等.小肠腺癌63例诊治分析[J].临床外科杂志,2017,25(7):534-536.]
[23] Gwon DI,Ko GY,Kwon YB,et al.Plug-assisted retrograde transvenous obliteration for the treatment of gastric varices:The role of intra-procedural cone-beam computed tomography[J].Korean J Radiol,2018,19(2):223-229.
[24] Motsumi MJ,Motlaleselelo P,Ayane G,et al.A case report of a giant appendiceal mucocele and literature review[J].Pan Afr Med J,2017,4(28):106.