Omori Teppei, Nakamura Shinichi, Shiratori Keiko
Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Digestion. 2015;91(4):318-25. doi: 10.1159/000381471. Epub 2015 May 19.
BACKGROUND/AIMS: A patency capsule (PC) is used to assess intestinal patency in patients with known or suspected stricture, but PC localization by plain abdominal X-ray (AXR) is difficult in those patients in whom the PC is not detected in the feces. Tomosynthesis is a promising, cost-effective, and low-radiation digital tomographic technique. This prospective study evaluated its use for PC localization in the intestinal tract.
The study subjects were 49 patients in whom the PC was not detected in the feces and was identified intra-abdominally on AXR films. PC localization in the small or large intestines by AXR alone or by tomosynthesis with AXR was compared with abdominal computed tomography (CT), which is the gold standard.
The PC was judged in the large and small intestines in 22 and 27 patients by AXR alone versus 34 and 15 patients, respectively, by tomosynthesis combined with AXR. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for PC detection by AXR alone were 52.9, 53.3, 56.2, 50.0, and 53.1%, respectively. The same parameters were 100, 100, 100, 100, and 100%, respectively, for tomosynthesis with AXR, which were identical to those of CT.
Tomosynthesis with AXR is superior to AXR alone, though similar to CT, with respect to localization of the PC.
背景/目的：通畅性胶囊（PC）用于评估已知或疑似肠道狭窄患者的肠道通畅情况，但对于那些粪便中未检测到PC的患者，通过腹部X线平片（AXR）定位PC很困难。断层合成是一种有前景、经济高效且辐射低的数字断层扫描技术。这项前瞻性研究评估了其在肠道中用于PC定位的情况。
研究对象为49例粪便中未检测到PC但在AXR片上腹部内可识别的患者。将单独使用AXR或AXR联合断层合成在小肠或大肠中进行PC定位与作为金标准的腹部计算机断层扫描（CT）进行比较。
单独使用AXR判断PC在大肠和小肠中的患者分别为22例和27例，而AXR联合断层合成判断在大肠和小肠中的患者分别为34例和15例。单独使用AXR检测PC的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为52.9%、53.3%、56.2%、50.0%和53.1%。AXR联合断层合成的相同参数分别为100%、100%、100%、100%和100%，与CT相同。
就PC的定位而言，AXR联合断层合成优于单独使用AXR，尽管与CT相似。
