肠腔充盈超声造影在大肠疾病检查中的应用价值

Value of bowel contrast ultrasonography in colorectal diseases

摘要:

目的  探讨肠腔充盈超声造影在大肠疾病检查中的应用价值，寻找一种简便、经济、有效的大肠检查方法。方法  对126例经病理组织学证实的大肠疾病患者行经腹超声检查（CTUS）、肠腔充盈超声造影检查（BCUS）、肠镜检查，并进行对照研究。BCUS检查是从直肠-回盲部-直肠进行多角度、多切面扫查，观察肠壁的结构层次、肠黏膜的连续性，病变的形态、大小、内部回声、活动度，病变与肠管周围组织器官的关系，并对病变进行定位，比较BCUS和CTUS对大肠疾病的检出、定位准确性的差异。以病理结果为金标准，比较BCUS和肠镜对各大肠疾病诊断符合率的差异。结果  126例患者CTUS检出病灶64个（64/126），检出率为50.8%；BCUS检出病灶109个（109/126），检出率为86.5%，两种方法检出率比较差异有统计学意义（P <0.05）。BCUS对大肠病变的定位符合率为90.8%（99／109），CTUS对大肠病变的定位符合率为29.7%（19／64），两种方法比较差异有统计学意义（P <0.05）。126例大肠病变，其中肠息肉41例，肠癌40例，克罗恩病（CD）21例，溃疡性结肠炎（UC）19例，间质瘤5例，BCUS与肠镜对各病变的诊断符合率比较，差异无统计学意义（P >0.05）。结论  BCUS在大肠病变检出、定位准确性方面优于CTUS。BCUS与肠镜检查形成互补，有助于提高大肠疾病的诊断率，值得临床推广应用。

Abstract:

Objective To investigate the value of bowel contrast ultrasonography (BCUS) of the colorectal diseases, to find a simple, economical and effective colorectal screening method. Methods A total of 126 cases with  pathologically-confirmed colorectal diseases underwent routine transabdominal ultrasonography (CTUS), BCUS and colonoscopy were compared. BCUS check started from rectum, cecum to rectum, were dia-gonal multi-faceted multi-slice scanning; the structure of the intestinal wall, intestinal mucosal continuity, lesion morphology, size, internal echo and activity were observed; the relationships between intestinal lesions and surrounding tissues and organs were also observed, the lesions were located. The differences in the colorectal disease detection and positioning accuracy were compared between BCUS and CTUS. Using pathological results as the gold standard, the difference in the diagnostic rate of colorectal diseases by BCUS and colonoscopy were compared. Results In the 126 patients, CTUS detected 64 lesions (64/126), the detection rate was 50.8%; BCUS detected 109 lesions (109/126), the detection rate was 86.5%; the difference in the detection rate was statistically significant (P < 0.05). BCUS coincidence rate of colorectal lesion location was 90.8% (99/109), CTUS coincidence rate of colorectal lesions was 29.6% (19/64), the difference between the two methods was statistically significant (P < 0.05). Among the 126 cases of colorectal lesions, there were 41 cases of intestinal polyps, 40 cases of colon cancers, 21 cases of Crohn's disease, 19 cases of ulcerative colitis and 5 cases of stromal tumors. BCUS and colonoscopy had no significant differences in the coincidence rates of diagnosis of various lesions (P > 0.05). Conclusions BCUS is better in colorectal lesion detection and positioning accuracy than CTUS. BCUS and colonoscopy complement can help to improve the diagnosis of colorectal diseases, and are worthy of clinical application.