多层螺旋CT增强扫描在胃肠道血管畸形诊断中的应用价值(1)
[摘要]目的 研究多層螺旋CT增强扫描在胃肠道血管畸形诊断中的应用价值。方法 选取2017年6月～2018年9月广州市白云区中医医院收治的60例疑似胃肠道血管畸形患者作为研究对象。所有患者均接受多层螺旋CT增强扫描检查和经数字减影血管造影检查，以经数字减影血管造影检查作为金标准，记录多层螺旋CT增强扫描影像学表现，统计多层螺旋CT增强扫描检查的灵敏度、特异度、诊断符合率以及多层螺旋CT增强扫描对胃肠道血管畸形供血动脉、引流静脉以及动静脉瘘的显示率。结果 32例患者经多层螺旋CT增强扫描确诊为胃肠道血管畸形，增强扫描时，动脉期可显示明显强化的条状/结节状/片状迂曲病变或不规则的异常血管团，门静脉期和平衡期则可发现病变强化程度下降迅速，病变处血管壁可见增厚现象，但血管腔内未见明显狭窄。多层螺旋CT增强扫描检查的灵敏度、特异度、诊断符合率(96.88%、96.43%、96.67%)与经数字减影血管造影检查(100.00%、100.00%、100.00%)比较，差异均无统计学意义(P>0.05)。多层螺旋CT增强扫描检查对供血动脉、动静脉瘘的显示率(96.88%、75.00%)与经数字减轻血管造影(100.00%、81.25%)比较，差异无统计学意义(P>0.05);多层螺旋CT增强扫描检查对引流静脉的显示率(68.75%)低于经数字减轻血管造影(100.00%)，差异有统计学意义(P<0.05)。结论 多层螺旋CT增强扫描检查可较为清楚、准确地显示胃肠道血管畸形部位、范围和形态，该方式诊断胃肠道血管畸形的灵敏度、特异度以及诊断符合率与金标准较为接近，可作为胃肠道血管畸形重要的筛查手段之一。
[关键词]多层螺旋CT增强扫描;经数字减影血管造影;胃肠道血管畸形;灵敏度;特异度
[中图分类号] R814.42 [文献标识码] A [文章编号] 1674-4721(2020)3(c)-0111-04
Application value of multi-slice spiral CT enhanced scan in the diagnosis of gastrointestinal vascular malformation
LI Yi-liang1 ZHANG Chun-xia1 LI Yong1 ZENG Qing-le2
1. Department of Imaging， Baiyun District Hospital of Traditional Chinese Medicine， Guangzhou City， Guangdong Province， Guangzhou 510470， China; 2. Department of Intervention， Nanfang Hospital， Southern Medical University， Guangdong Province， Guangzhou 510470， China
[Abstract] Objective To study the application value of multi-slice spiral CT enhanced scan in the diagnosis of gastrointestinal vascular malformation. Methods A total of 60 patients suspected with gastrointestinal vascular malformation treated in Baiyun District Hospital of Traditional Chinese Medicine， Guangzhou City from June 2017 to September 2018 were selected as research objects. The multi-slice spiral CT enhanced scan and digital subtraction angiography were performed， and the digital subtraction angiography examination results were taken as golden standard. The clinical manifestations as well as diagnosis sensitivity， specificity and accordance rate of multi-slice spiral CT enhanced scan were recorded and counted. The display rate of gastrointestinal vascular malformation in the feeding artery， draining vein and arterio-venous fistula based on CT was analyzed. Results Through multi-slice spiral CT enhanced scan examination， 32 patients were confirmed with gastrointestinal vascular malformation. At arterial phase， CT enhanced scan showed obviously strengthened strip， nodular or flake-shaped tortuous lesions or irregular vascular anomaly. At portal venous phase and equilibrium phase， the enhanced degree was substantially declined with thickened blood vessel wall while no obvious stenosis appeared in lumen. The diagnosis sensitivity， specificity and accordance rate based on multi-slice spiral CT enhanced scan (96.86%， 96.43%， 96.67%) and digital subtraction angiography (100.00%， 100.00%， 100.00%) showed no statistically significant differences (P>0.05). The display rate of gastrointestinal vascular malformation in the feeding artery and arterio-venous fistula based on multi-slice spiral CT enhanced scan (96.88%， 75.00%) and digital subtraction angiography (100.00%， 81.25%) showed no statistically significant differences (P>0.05). The display rate of gastrointestinal vascular malformation in the draining vein based on multi-slice spiral CT enhanced scan (68.75%) was lower than that of digital subtraction angiography (100.00%)， with statistically significant difference (P<0.05). Conclusion Based on multi-slice spiral CT enhanced scan， the position， range and morphology of gastrointestinal vascular malformation can be clearly and accurately displayed. Owing to its high diagnosis sensitivity， specificity and accordance rate， multi-slice spiral CT enhanced scan may be served as the major method for screening of gastrointestinal vascular malformation., http://www.100md.com(李宜亮 张春霞 李勇 曾庆乐)
[关键词]多层螺旋CT增强扫描;经数字减影血管造影;胃肠道血管畸形;灵敏度;特异度
[中图分类号] R814.42 [文献标识码] A [文章编号] 1674-4721(2020)3(c)-0111-04
Application value of multi-slice spiral CT enhanced scan in the diagnosis of gastrointestinal vascular malformation
LI Yi-liang1 ZHANG Chun-xia1 LI Yong1 ZENG Qing-le2
1. Department of Imaging， Baiyun District Hospital of Traditional Chinese Medicine， Guangzhou City， Guangdong Province， Guangzhou 510470， China; 2. Department of Intervention， Nanfang Hospital， Southern Medical University， Guangdong Province， Guangzhou 510470， China
[Abstract] Objective To study the application value of multi-slice spiral CT enhanced scan in the diagnosis of gastrointestinal vascular malformation. Methods A total of 60 patients suspected with gastrointestinal vascular malformation treated in Baiyun District Hospital of Traditional Chinese Medicine， Guangzhou City from June 2017 to September 2018 were selected as research objects. The multi-slice spiral CT enhanced scan and digital subtraction angiography were performed， and the digital subtraction angiography examination results were taken as golden standard. The clinical manifestations as well as diagnosis sensitivity， specificity and accordance rate of multi-slice spiral CT enhanced scan were recorded and counted. The display rate of gastrointestinal vascular malformation in the feeding artery， draining vein and arterio-venous fistula based on CT was analyzed. Results Through multi-slice spiral CT enhanced scan examination， 32 patients were confirmed with gastrointestinal vascular malformation. At arterial phase， CT enhanced scan showed obviously strengthened strip， nodular or flake-shaped tortuous lesions or irregular vascular anomaly. At portal venous phase and equilibrium phase， the enhanced degree was substantially declined with thickened blood vessel wall while no obvious stenosis appeared in lumen. The diagnosis sensitivity， specificity and accordance rate based on multi-slice spiral CT enhanced scan (96.86%， 96.43%， 96.67%) and digital subtraction angiography (100.00%， 100.00%， 100.00%) showed no statistically significant differences (P>0.05). The display rate of gastrointestinal vascular malformation in the feeding artery and arterio-venous fistula based on multi-slice spiral CT enhanced scan (96.88%， 75.00%) and digital subtraction angiography (100.00%， 81.25%) showed no statistically significant differences (P>0.05). The display rate of gastrointestinal vascular malformation in the draining vein based on multi-slice spiral CT enhanced scan (68.75%) was lower than that of digital subtraction angiography (100.00%)， with statistically significant difference (P<0.05). Conclusion Based on multi-slice spiral CT enhanced scan， the position， range and morphology of gastrointestinal vascular malformation can be clearly and accurately displayed. Owing to its high diagnosis sensitivity， specificity and accordance rate， multi-slice spiral CT enhanced scan may be served as the major method for screening of gastrointestinal vascular malformation., http://www.100md.com(李宜亮 张春霞 李勇 曾庆乐)