使用泡腾粉进行多排螺旋 CT 检测和分级食管静脉曲张的诊断性能。

Diagnostic performance of using effervescent powder for detection and grading of esophageal varices by multi-detector computed tomography.

机构信息

Department of Radiology, Karadeniz Technical University School of Medicine, Farabi Hospital, 61080 Trabzon, Turkey.

出版信息

Eur J Radiol. 2014 Mar;83(3):497-502. doi: 10.1016/j.ejrad.2013.11.014. Epub 2013 Dec 4.

DOI:10.1016/j.ejrad.2013.11.014

PMID:24355657

Abstract

PURPOSE

To investigate the effect of using effervescent powder (EP) on the efficacy of multi-detector computed tomography (MDCT) in detection and grading of esophageal varices in cirrhotic patients by considering endoscopy as the gold standard.

MATERIALS AND METHODS

Ninety-two cirrhotic patients undergoing biphasic liver MDCT followed by upper gastrointestinal endoscopy within 4 weeks of MDCT were prospectively evaluated. The patients were divided into two groups before MDCT. The first group (n=50) received effervescent powder (EP) before and during MDCT procedure and the second group did not receive (n=42). The presence, size and grade of the esophageal varices were evaluated. MDCT findings were compared with endoscopic results. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of MDCT with EP and without EP were calculated and compared. Correlations between the grades of the varices for each group based on MDCT imaging and endoscopic grading were also evaluated.

RESULTS

The sensitivity, specificity, accuracy, PPV, and NPV of MDCT were 100%, 88%, 96%, 94%, and 100%, respectively, in the EP group, whereas they were 76%, 67%, 74%, 89%, and 43%, respectively, in the non-EP group. Correlations between the grades of the esophageal varices on MDCT and endoscopy were significant in both groups (r=0.94, p<0.001 for EP group and r=0.70, p<0.001 for non-EP group).

CONCLUSION

During periodic CT scanning of cirrhotic patients, use of EP increases the success rate of MDCT for detection and grading of esophageal varices.

摘要

目的

通过以胃镜为金标准，研究在肝硬化患者中使用泡腾粉（EP）对多排螺旋 CT（MDCT）检测和分级食管静脉曲张的效果。

材料与方法

前瞻性评估 92 例在 MDCT 后 4 周内行上消化道内镜检查的肝硬化患者。在 MDCT 前将患者分为两组。第一组（n=50）在 MDCT 检查前和检查过程中使用 EP，第二组（n=42）未使用 EP。评估食管静脉曲张的存在、大小和分级。将 MDCT 结果与内镜结果进行比较。计算并比较 EP 和无 EP 组 MDCT 的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。还评估了根据 MDCT 成像和内镜分级，每组之间的静脉曲张程度之间的相关性。

结果

EP 组 MDCT 的敏感性、特异性、准确性、PPV 和 NPV 分别为 100%、88%、96%、94%和 100%，而非 EP 组分别为 76%、67%、74%、89%和 43%。两组中 MDCT 上食管静脉曲张的分级与内镜检查均呈显著相关（EP 组 r=0.94，p<0.001；非 EP 组 r=0.70，p<0.001）。