Orjollet-Lecoanet C, Ménard Y, Martins A, Crombé-Ternamian A, Cotton F, Valette P J
Service de Radiologie digestive et interventionnelle, Pavillon H Radiologie, Hopital Edouard Herriot, Place d'Arsonval, 69437 Lyon Cedex 03.
J Radiol. 2000 Jun;81(6):618-27.
To assess the feasibility and the usefulness of CT enteroclysis (helical CT with enteroclysis) in detecting small bowel tumors.
Fifty patients were referred for suspicion of small bowel tumor. CT enteroclysis is performed by injecting a large volume of water using a pomp through a nasojejunal tube followed by a thin section helical acquisition.
Forty-eight helical CT enteroclysis were performed in order to detect 25 small bowel tumors. Among them 22 were confirmed by histological study. The mean size of tumors was 23 mm. In 12 of 17 cases, diagnosis was missed or incomplete at conventional barium study. Enteroscopy was performed in 12 of 22 cases, with discordant result in one case and incomplete result in 3 cases. In 8 cases, including 5 carcinoid tumors, patients had surgery after CT enteroclysis only, enteroscopy would probably have not made the diagnosis because the lesions were far from the duodenojejunal junction and ileocaecal valve.
Helical CT enteroclysis is a new method for detecting small bowel tumors, easy to perform, well tolerated. It seems to be more sensitive than conventional barium studies and less invasive than enteroscopy. Tumor characterization and staging can be performed using a single examination. It seems to be justified to perform CT enteroclysis to detect small bowel tumors or in the evaluation of patients with polyposis.
评估CT小肠造影(螺旋CT小肠造影)在检测小肠肿瘤中的可行性和实用性。
50例因怀疑小肠肿瘤而转诊的患者。CT小肠造影是通过鼻空肠管使用泵注入大量水,随后进行薄层螺旋扫描来完成的。
为检测25例小肠肿瘤进行了48次螺旋CT小肠造影。其中22例经组织学研究证实。肿瘤平均大小为23毫米。在17例中的12例中,传统钡剂造影检查漏诊或诊断不完整。22例中的12例进行了小肠镜检查,1例结果不一致,3例结果不完整。在8例中,包括5例类癌肿瘤,患者仅在CT小肠造影后接受了手术,小肠镜检查可能无法做出诊断,因为病变远离十二指肠空肠交界处和回盲瓣。
螺旋CT小肠造影是一种检测小肠肿瘤的新方法,操作简便,耐受性好。它似乎比传统钡剂造影更敏感,比小肠镜检查侵入性更小。使用单次检查即可进行肿瘤特征描述和分期。进行CT小肠造影以检测小肠肿瘤或评估息肉病患者似乎是合理的。