Tamamoto F, Ozaki Y, Amemiya K, Shirakata A, Sumi Y, Katayama H
Department of Radiology, Juntendo Urayasu Hospital.
Nihon Igaku Hoshasen Gakkai Zasshi. 1990 Jul 25;50(7):792-7.
In pelvic CT, several techniques (appropriate preparations) have been reported for the optimal diagnostic imagings. We demonstrated the usefulness and limitations of "Air Enema", which is one of preparations for hollow viscera in pelvic CT examination. From Oct. 1986 to Mar. 1987, 38 patients with gynecological abnormalities were evaluated by consecutive pre and post "Air Enema" CT. The patients aged 26-75 years with mean of 44.6 years. All patients were examined in prone position with 100 ml of 2% iopamidol in the urinary bladder and medical tampon in the vagina. Two consecutive scans were performed from the level of pubic symphysis to the 5th lumbar vertebra at 10 mm-15 mm intervals. The first scan was pre "Air Enema" CT, in which the rectum, entire colon and terminal ileum were not distended. The second scan was post "Air Enema" CT, in which the hollow viscera was distended by 1000 ml-1500 ml of air. Two images, each from pre and post "Air Enema" CT were evaluated on the efficacy for imaging diagnosis. In "Air Enema" CT, main useful effect was "replacement effect", which was that intrapelvic masses and/or intrapelvic paravascular spaces were clearly delineated by distended bowels. Detection and location of intrapelvic masses were correctly diagnosed when the masses were relatively small (5.3 cm in average diameter), but there were no advantages in cases in which the pelvic masses were large enough to occupy the pelvic cavity (12.7 cm in average diameter). Abdominal pain was the most common adverse reaction to this technique. But complaints usually disappeared in few hours after examination. Thus, "Air Enema" seems to be useful preparation for pelvic CT examination to detect relatively small intrapelvic masses and abnormalities.
在盆腔CT检查中，已有多种技术（适当的准备工作）被报道用于获得最佳诊断影像。我们展示了“空气灌肠”的实用性和局限性，它是盆腔CT检查中空脏器的一种准备方法。1986年10月至1987年3月，对38例妇科异常患者进行了连续的“空气灌肠”前后CT评估。患者年龄在26至75岁之间，平均年龄为44.6岁。所有患者均取俯卧位，膀胱内注入100毫升2%碘帕醇，阴道内放置医用棉塞。从耻骨联合水平至第5腰椎椎体，以10毫米至15毫米的间隔进行连续两次扫描。第一次扫描是“空气灌肠”前CT，此时直肠、整个结肠和回肠末端未扩张。第二次扫描是“空气灌肠”后CT，此时中空脏器被1000毫升至1500毫升空气扩张。对“空气灌肠”前后CT的各两张图像进行成像诊断效果评估。在“空气灌肠”CT中，主要的有用效果是“替代效应”，即扩张的肠管能清晰勾勒出盆腔内肿块和/或盆腔内血管旁间隙。当盆腔肿块相对较小（平均直径5.3厘米）时，能正确诊断其位置，但对于足够大以占据盆腔腔的盆腔肿块（平均直径12.7厘米），该方法并无优势。腹痛是该技术最常见的不良反应。但这些不适通常在检查后数小时内消失。因此，“空气灌肠”似乎是盆腔CT检查中用于检测相对较小盆腔肿块和异常的有用准备方法。
