Zhang Shu-Hui, Fan Ming-Wei, Chen Yan, Hu Ying-Bin, Liu Cheng-Xia
Department of Gastroenterology, Binzhou Medical University Hospital, Binzhou 256600, Shandong Province, China.
World J Clin Cases. 2024 Jun 6;12(16):2831-2836. doi: 10.12998/wjcc.v12.i16.2831.
Computed tomography (CT) small bowel three-dimensional (3D) reconstruction is a powerful tool for the diagnosis of small bowel disease and can clearly show the intestinal lumen and wall as well as the outside structure of the wall. The horizontal axis position can show the best adjacent intestinal tube and the lesion between the intestinal tubes, while the coronal position can show the overall view of the small bowel. The ileal end of the localization of the display of excellent, and easy to quantitative measurement of the affected intestinal segments, the sagittal position for the rectum and the pre-sacral lesions show the best, for the discovery of fistulae is also helpful. Sagittal view can show rectal and presacral lesions and is useful for fistula detection. It is suitable for the assessment of inflammatory bowel disease, such as assessment of disease severity and diagnosis and differential diagnosis of the small bowel and mesenteric space-occupying lesions as well as the judgment of small bowel obstruction points.
Bleeding caused by small intestinal polyps is often difficult to diagnose in clinical practice. This study reports a 29-year-old male patient who was admitted to the hospital with black stool and abdominal pain for 3 months. Using the combination of CT-3D reconstruction and capsule endoscopy, the condition was diagnosed correctly, and the polyps were removed using single-balloon enteroscopy-endoscopic retrograde cholangiopancreatography without postoperative complications.
The role of CT-3D in gastrointestinal diseases was confirmed. CT-3D can assist in the diagnosis and treatment of gastrointestinal diseases in combination with capsule endoscopy and small intestinal microscopy.
计算机断层扫描（CT）小肠三维（3D）重建是诊断小肠疾病的有力工具，能够清晰显示肠腔、肠壁以及肠壁外结构。横轴位能最佳显示相邻肠管及肠管间病变，冠状位可展示小肠全貌。矢状位对回肠末端显示极佳，便于对病变肠段进行定量测量，对直肠及骶前病变显示最佳，对发现瘘管也有帮助。矢状位可显示直肠和骶前病变，有助于瘘管检测。它适用于评估炎症性肠病，如评估疾病严重程度、诊断和鉴别诊断小肠及肠系膜占位性病变以及判断小肠梗阻部位。
小肠息肉引起的出血在临床实践中常难以诊断。本研究报告一名29岁男性患者，因黑便和腹痛3个月入院。采用CT-3D重建与胶囊内镜相结合的方法，正确诊断病情，并通过单气囊小肠镜-内镜逆行胰胆管造影术切除息肉，术后无并发症。
证实了CT-3D在胃肠道疾病中的作用。CT-3D可与胶囊内镜及小肠镜检查相结合，辅助胃肠道疾病的诊断与治疗。
