Department of Surgery, Jichi Medical University, Tochigi-ken, Japan.
Dig Endosc. 2010 Jul;22(3):205-10. doi: 10.1111/j.1443-1661.2010.00986.x.
There are no studies to date using air as an enteral contrast medium for small bowel expansion in virtual enteroscopy. We examine the feasibility of air as an enteral contrast medium for virtual enteroscopy to achieve small bowel expansion.
Two volunteers and six patients were examined. The six patients included three with small bowel tumors, one with small bowel hemorrhage and two with suspected cases of post-operative small bowel stenosis. A duodenal tube was inserted under fluoroscopy and approximately 2000 ml air was administered prior to scanning. A 16-detector row computed tomography apparatus was used with 2-mm thick slices. Intravenous contrast material was administered to the patients, but not to the volunteers. Computed tomography scanning was performed two to three times until the air reached the colon. Two examiners reconstructed multi-planar reformation, volume rendering and virtual endoscopy. These images were compared with double balloon enteroscopic findings and/or resected specimens.
There were no complications associated with this examination. In the volunteers the difference between the circular folds of the jejunum and those of the ileum was clearly visualized on virtual endoscopy. Angiodysplasia (9 mm), gastrointestinal stromal tumor (15 mm) and arteriovenous malformation were clearly detected by virtual endoscopy. In contrast, one tumor could not be detected because of inadequate intestinal distension. In the two suspected cases of the stenosis, the lesion was not identified because stenotic lesions were not differentiated from normal peristalsis of the small bowel.
Air is a feasible enteral contrast material for virtual enteroscopy.
目前尚无研究使用空气作为虚拟内镜小肠扩张的肠内对比介质。我们研究了空气作为虚拟内镜肠内对比介质以实现小肠扩张的可行性。
对 2 名志愿者和 6 名患者进行了检查。6 名患者中包括 3 名小肠肿瘤患者、1 名小肠出血患者和 2 名疑似术后小肠狭窄患者。在透视引导下插入十二指肠管，在扫描前给予约 2000 毫升空气。使用 16 排 CT 仪进行 2 毫米厚的切片。向患者而非志愿者静脉内给予对比剂。对患者进行 CT 扫描 2-3 次，直到空气到达结肠。两名检查者重建多平面重建、容积再现和虚拟内镜。将这些图像与双气囊内镜检查结果和/或切除标本进行比较。
该检查无并发症。在志愿者中，虚拟内镜可清晰显示空肠和回肠的环形褶皱之间的差异。血管发育不良（9 毫米）、胃肠道间质瘤（15 毫米）和动静脉畸形均可通过虚拟内镜清晰检测到。相比之下，由于肠腔扩张不足，无法检测到一个肿瘤。在两个狭窄疑似病例中，由于狭窄病变与小肠正常蠕动无法区分，因此无法识别病变。
空气是虚拟内镜可行的肠内对比介质。
