Department of Gastrointestinal Radiology, Hôpital Edouard Herriot, 5 Place d'Arsonval, 69003 Lyon, France.
AJR Am J Roentgenol. 2010 Mar;194(3):629-33. doi: 10.2214/AJR.09.2760.
The purpose of this study was to evaluate the value of CT enteroclysis in depicting small-bowel carcinoid tumors in symptomatic patients with surgical, histologic, or clinical follow-up findings as a reference standard.
At our institution, 44 patients with symptoms of suspected gastrointestinal carcinoid tumors underwent CT enteroclysis. Clinical symptoms were as follows: carcinoid syndrome (n = 3), abdominal pain with diarrhea (n = 24), hypervascular liver metastases (n = 7), subileus condition (n = 1), hypervascular peritoneal lesion (n = 3), abnormal ileal stenosis on optical colonoscopy (n = 3), and follow-up extraintestinal carcinoid lesion (n = 3). Positive CT enteroclysis findings were compared with pathology results after surgical procedures (n = 19). Negative examinations were compared with surgery results (n = 3) or clinical follow-up (n = 22).
CT enteroclysis findings were positive in 19 patients and negative in 25 patients. The sizes of the carcinoid tumors identified were 5-30 mm in axial diameter. These tumors were depicted as focal nodular lesions located in the small-bowel wall or as intraluminal polypoid masses with marked enhancement. Twenty-two patients underwent only clinical follow-up, with a mean clinical follow-up time of 20 months. The overall sensitivity and specificity of CT enteroclysis in identifying patients with small-bowel carcinoid tumors were 100% and 96.2%, respectively. The negative predictive value of CT enteroclysis was 100% and the positive predictive value, 94.7%. Pathologic findings confirmed small-bowel carcinoid tumors in 18 patients.
CT enteroclysis should be considered an excellent tool for the diagnosis of the carcinoid tumor before any surgical procedures.
本研究旨在评估 CT 肠造影在有手术、组织学或临床随访结果作为参考标准的症状性患者中小肠类癌肿瘤的描绘价值。
在我们的机构中，44 例有疑似胃肠道类癌肿瘤症状的患者接受了 CT 肠造影。临床症状如下：类癌综合征（n=3）、腹痛伴腹泻（n=24）、肝血供转移瘤（n=7）、亚肠梗阻状态（n=1）、血供丰富的腹膜病变（n=3）、光学结肠镜下异常回肠狭窄（n=3）和随访的肠外类癌病变（n=3）。阳性 CT 肠造影结果与手术病理结果（n=19）进行比较。阴性检查与手术结果（n=3）或临床随访（n=22）进行比较。
CT 肠造影结果阳性 19 例，阴性 25 例。类癌肿瘤的大小在轴向直径为 5-30mm。这些肿瘤被描绘为位于小肠壁的局灶性结节性病变，或呈腔内息肉样肿块，有明显强化。22 例仅进行临床随访，平均临床随访时间为 20 个月。CT 肠造影对小肠类癌肿瘤患者的总体敏感性和特异性分别为 100%和 96.2%。CT 肠造影的阴性预测值为 100%，阳性预测值为 94.7%。病理检查证实 18 例为小肠类癌肿瘤。
在任何手术前，CT 肠造影应被视为诊断类癌肿瘤的优秀工具。
