Department of Gastroenterology, Endoscopy Center, Changhua Christian Hospital, 500 Changhua, Taiwan, China.
World J Gastroenterol. 2012 Feb 21;18(7):692-7. doi: 10.3748/wjg.v18.i7.692.
To evaluate the clinical impact of multidetector computed tomography (MDCT) before double-balloon endoscopy (DBE) for patients with obscure gastrointestinal bleeding (OGIB).
A retrospective analysis of prospectively collected cases with DBE and MDCT for overt OGIB was conducted from April 2004 to April 2010 at Changhua Christian Hospital. We evaluated the clinical impact of MDCT on the subsequent DBE examinations and the diagnostic yields of both MDCT and DBE respectively.
From April 2004 to April 2010, a total of 75 patients underwent DBE for overt OGIB. Thirty one cases received MDCT followed by DBE for OGIB. The overall diagnostic yields of DBE and MDCT was 93.5% and 45.2%. The MDCT had a high diagnostic yield of tumor vs non-tumor etiology of OGIB (85.7% vs 33.3%, P = 0.014). Additionally, the choice of initial route of DBE was correct in those with a positive MDCT vs negative MDCT (100% vs 52.9%, P = 0.003).
This study suggests MDCT as a triage tool may identify patients who will benefit from DBE and aid the endoscopist in choosing the most efficient route.
评估多排螺旋 CT（MDCT）在双气囊内镜（DBE）检查用于不明原因胃肠道出血（OGIB）患者前的临床影响。
对 2004 年 4 月至 2010 年 4 月在彰化基督教医院接受 DBE 和 MDCT 检查的显性 OGIB 患者进行前瞻性收集病例的回顾性分析。我们评估了 MDCT 对随后的 DBE 检查的临床影响，以及 MDCT 和 DBE 的诊断效果。
2004 年 4 月至 2010 年 4 月，共有 75 例患者因显性 OGIB 接受 DBE 检查。31 例患者在 OGIB 接受 MDCT 检查后行 DBE 检查。DBE 和 MDCT 的总体诊断率分别为 93.5%和 45.2%。MDCT 对 OGIB 的肿瘤病因与非肿瘤病因的诊断率较高（85.7%比 33.3%，P=0.014）。此外，MDCT 阳性患者与 MDCT 阴性患者的初始 DBE 检查路径选择正确（100%比 52.9%，P=0.003）。
本研究表明，MDCT 作为一种分诊工具，可能有助于识别受益于 DBE 检查的患者，并帮助内镜医生选择最有效的检查路径。
