双气囊小肠镜和多层螺旋CT对小肠肿瘤的诊断价值

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。
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