两种口服造影剂在CT小肠造影中的对比研究(1)
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[摘要] 目的 对比两种口服造影剂在多层螺旋CT小肠造影中的应用。 方法 44例临床患者(40～60岁)随机分为两组，分别使用常规法(碘伏醇水溶液)和改良法(甘露醇+碘伏醇水溶液)进行多层螺旋CT全腹扫描。按影像学解剖将小肠分为6段(1段为十二指肠，2段为空肠近端，3段为空肠远端，4、5、6段为回肠)，用双盲法对两组图像中小肠肠腔充盈度进行评价及统计学分析。 结果 改良法对2、3、4段小肠肠腔充盈度均优于常规法，差异有统计学意义(P<0.05)；对1、5、6段小肠肠腔充盈度，两法差异无统计学意义(P均>0.05)。 结论 改良法对空肠及回肠上端肠腔充盈效果优于常规法，口服造影剂改良法的研究对多层螺旋CT小肠造影检查有一定意义。
[关键词] 造影剂；小肠造影
[中图分类号] R816.5 [文献标识码] B [文章编号] 1673-9701(2012)02-0095-02
Study and compare two oral contrast agents in CT enterography of small intestines
XING Xiaohui1 WU Zhifeng2 E Linning2
1.Department of Medical Imaging, Shanxi Medical University, Taiyuan 030001, China；2.Department of CT, the First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China
[Abstract] Objective To compare two oral contrast agents in multi-slice spiral CT enterography of small intestines. Methods Fourty-four patients (40-60 years old) were randomly divided into two groups and underwent conventional or optimized methods for multi-slice spiral CT total abdominal plain scan. According to the anatomy imaging divided small intestine into 6 sections, with the double blind method on 2 groups of images in the intestinal lumen of filling degree evaluation and statistical analysis. Results Optimized method was superior to conventional method in the expansion degree of the 2, 3 and 4 segments of the small intestine (P<0.05). There was no significant differences between two groups of conventional or optimized methods on the other segments of the small intestine (P>0.05). Conclusion Improvement on jejunal and upper ileal intestinal cavity filling effect is better than the routine method, modified method of oral contrast agent for multi-slice spiral CT angiography has certain significance of small intestine.
[Key words] Contrast agent; Small intestine imaging
小肠是人体胃肠道中最长的一段肌性管道，是消化与吸收营养物质的重要场所，同时肩负内分泌功能[1]。小肠病变虽不如胃和大肠病变多见，但也并非罕见，主要包括梗阻、缺血、肿瘤、炎症性肠病等；很多小肠疾病不但侵及肠壁、向腔内发展，还穿透肠壁向腔外浸润。小肠是胃镜、结肠镜检查的盲区，口服钡剂小肠造影费时，肠腔充盈不佳[2]；小肠钡剂灌肠及插管法小肠气钡双重造影对小肠病变的检出率明显提高[3]，但患者痛苦、医师操作复杂，且仅能观察肠内结构，不能很好显示肠壁和肠外结构，故很多医院不能广泛开展[4]；胶囊内镜检查费用昂贵，且存在较多检查盲区。由于小肠解剖结构复杂，且临床缺乏简便有效的检查手段，小肠疾病的临床诊疗效果不甚理想[5，6]，以致病变较易遗漏、误诊，延误治疗。近年来，随着胃肠腔内对比剂的推广应用，CT小肠造影越来越受到重视 ......
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