摘要
目的:通过与数字减影血管造影(DSA)的对照分析,评价多层螺旋CT(MSCT)对下消化道出血的诊断价值。方法:临床怀疑下消化道出血的29例患者进行MSCT增强扫描,并结合MSCT多平面重组(MPR)、最大密度投影(MIP)等后处理模式对图像进行分析判断,找出出血部位及供血动脉,与DSA对照来评估MSCT血管成像技术对于显示下消化道出血的敏感性、准确率。结果:①MSCT显示出血部位25例,出血显示率86.2%(25/29)。DSA检查发现出血灶22例,出血显示率75.9%(22/29)。MSCT对于发现出血部位的敏感性和DSA无显著差异(P>0.05)。②MSCT显示以下出血部位:空回肠出血9例,结肠出血16例,诊断肿瘤15例,炎症4例,憩室2例,溃疡2例,血管畸形1例,未明确病因1例。MSCT未见异常的4例DSA均表现阴性。DSA显示的出血部位:小肠8例,结肠14例,术中诊断肿瘤10例,血管畸形1例,其余11例未明确病因。统计结果表明:MSCT对于下消化道出血的病因诊断准确率明显高于DSA(P<0.05)。结论:MSCT对于判断下消化道出血部位的敏感性可与DSA相媲美,并且能较准确地进行病因诊断,具有较高的临床应用价值,可作为下消化道出血性疾病的常规首选检查方法。
Objective： To evaluate multislice spiral CT（MSCT） in the diagnosis of lower digestive tract hemorrhage as compared with digital subtraction angiography（DSA）.Methods： Twenty-nine cases of suspected lower digestive tract bleeding received MSCT enhanced scan,combined with multiplanar reformation（MPR）,maximum intensity projection（MIP） image analysis,to identify the bleeding site and the supplying artery.The results were compared with those of DSA to evaluate the sensitivity and accuracy of MSCT.Results： MSCT showed the bleeding sites of the 25 cases（86.2%） while DSA found 22 sites of bleeding（75.9%）.MSCT showed 9 cases of jejunum and ileum bleeding,16 cases of colonic bleeding,15 cases of tumor,4 cases of inflammation,two cases of diverticulitis,two cases of ulcers,one case of vascular malformation,and no clear cause for bleeding in one case.The four cases did not show bleeding site in MSCT were also negative in DSA.DSA showed 8 cases of small intestine bleeding and 14 cases of colon bleeding.After operation,ten bleeding cases were diagnosed as tumors,one diagnosed as vascular malformation,and 11 cases did not find the bleeding causes.The accuracy of MSCT in diagnosis of the cause of lower gastrointestinal bleeding is significantly higher than that of DSA（P0.05）.Conclusion： In similar to DSA,MSCTA can well display the bleeding sites for lower digestive tract hemorrhage,furthermore,it has a high clinical value in etiological diagnosis.
出处
《武汉大学学报（医学版）》
CAS
北大核心
2012年第6期888-892,共5页
Medical Journal of Wuhan University
