CTE在小肠肿瘤性病变中的应用价值研究

发布时间：2018-03-06 03:03

本文选题：CT小肠造影　切入点：小肠肿瘤　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:1.探讨山莨菪碱对CT小肠造影检查的影响。2.探讨CT小肠造影在小肠肿瘤性病变诊断中的应用价值。材料与方法:A组:选择患者40人,分成实验组与对照组,各20人,实验组肌注山莨菪碱低张肠道,对照组不应用山莨菪碱,为空白对照;对十二指肠、空肠及回肠的肠腔宽度、肠壁厚度及双期增强肠壁CT值进行测量,应用两独立样本Wilcoxon秩和检验;对肠腔充盈程度进行评分,采用两独立样本U检验;均以P0.05为差异有统计学意义。B组:回顾性分析2015年01月至2017年01月在我院进行CTE检查并经手术病理证实为小肠肿瘤性病变的患者,共32例,其中包括恶性肿瘤19例(淋巴瘤10例、腺癌9例),非恶性肿瘤及肿瘤样病变13例(间质瘤9例、血管瘤1例、异位胰腺2例及炎性假瘤1例)。分别测量恶性肿瘤、非恶性肿瘤及肿瘤样病变的肿瘤长径、肠腔残留率及三期CT值,对恶性肿瘤与非恶性肿瘤及肿瘤样病变进行比较。恶性肿瘤与非恶性肿瘤及肿瘤样病变的比较包括两部分,一部分为全部恶性肿瘤与非恶性肿瘤及肿瘤样病变的比较,另一部分为剔除淋巴瘤后的恶性肿瘤与非恶性肿瘤及肿瘤样病变的比较。均应用两独立样本Wilcoxon秩和检验,以P0.05为差异有统计学意义。结果:A组结果显示,十二指肠实验组与对照组肠腔宽度、肠腔充盈度评分及增强动脉期肠壁CT值差异均有统计学意义(P=0.000,P=0.017,P=0.015;P0.05);空肠实验组与对照组肠腔充盈度评分及增强动脉期肠壁CT值差异均有统计学意义(P=0.01,P=0.001;P0.05);回肠实验组与对照组肠腔充盈度评分及增强动脉期肠壁CT值差异均有统计学意义(P=0.005,P=0.003;P0.05)。十二指肠、空肠及回肠肠壁厚度差异均无统计学意义(P=0.079,P=0.116,P=0.818;P0.05);静脉期肠壁CT值差异均无统计学意义(P=0.685,P=0.358,P=0.13;P0.05)。B组结果显示恶性肿瘤中淋巴瘤与腺癌肿瘤长径及肠腔残留率差异有统计学意义(P=0.001,P=0.001;P0.05);动脉期CT值及静脉期CT值差异有统计学意义(P=0.007,P=0.014;P0.05);平扫CT值差异无统计学意义(P=0.109,P0.05)。在全部恶性肿瘤与非恶性肿瘤及肿瘤样病变的比较中,肿瘤长径、肠腔残留率差异有统计学意义(P=0.004,P=0.009;P0.05);平扫及动、静脉期CT值差异有统计学意义(P=0.012,P=0.010,P=0.016;P0.05)。剔除淋巴瘤后结果显示肿瘤长径、肠腔残留率、平扫CT值、动脉期及静脉期CT值差异均无统计学意义(P=0.295,P=0.642,P=0.218,P=0.0.79,P=0.235;P0.05)。结论:1.应用山莨菪碱的CTE图像质量优于不应用山莨菪碱。2.CTE能充分显示病变特征,依据肿瘤长径、肠腔残留率及肿瘤三期CT值的差异,可以为肿瘤性病变的诊断与鉴别诊断提供依据。
[Abstract]:Objective 1. To investigate the effect of anisodamine on CT enterography. 2. To explore the value of CT enterography in the diagnosis of small intestinal neoplasms. Materials and methods: group A: 40 patients were selected and divided into experimental group and control group, 20 patients in each group. In the experimental group, anisodamine was injected intramuscularly into the hypotonic intestine, while in the control group, anisodamine was not used as a blank control, and the width of the intestine, the thickness of the intestinal wall and the CT value of the enhanced intestinal wall in the duodenum, jejunum and ileum were measured. Wilcoxon rank sum test of two independent samples and U test of two independent samples were used to evaluate the filling degree of intestinal cavity. Group B: from January 2015 to January 2017, 32 patients who underwent CTE examination in our hospital and proved to be small intestinal neoplasms by operation and pathology were analyzed retrospectively. There were 19 cases of malignant tumor (10 cases of lymphoma, 9 cases of adenocarcinoma, 13 cases of non-malignant tumor and tumor-like lesion) (9 cases of stromal tumor, 1 case of hemangioma, 2 cases of ectopic pancreas and 1 case of inflammatory pseudotumor). The length of tumor, the residual rate of intestinal cavity and the third phase CT value of non-malignant tumor and tumor-like lesion were compared. The comparison between malignant tumor and non-malignant tumor and tumor-like lesion was made up of two parts: malignant tumor and non-malignant tumor and tumor-like lesion. One part was the comparison of all malignant tumors with non-malignant tumors and tumor-like lesions, the other was the comparison of malignant tumors and non-malignant tumors and tumor-like lesions after lymphoma removal. Two independent samples of Wilcoxon rank sum test were used. Results compared with control group, the width of duodenal lumen in the duodenal experimental group and control group was significantly higher than that in the control group (P 0.05). There were significant differences in the score of filling degree of intestinal cavity and the CT value of intestinal wall in enhanced arterial phase. There were significant differences in the score of filling degree of intestinal cavity between the jejunum experimental group and the control group and the CT value of the enhanced artery phase, and the difference between the ileum experimental group and the control group was statistically significant, and the difference between the ileum experimental group and the control group was significant. The ileum test group and the control group had significant differences in the score of the filling degree of the intestine and the CT value of the enhanced artery phase, the ileum test group and the control group had significant differences. In the radiographic group, there were significant differences in the score of filling degree of intestinal cavity and the CT value of intestinal wall in enhanced arterial phase. There were significant differences in duodenum, duodenum, duodenum, duodenum, duodenum, duodenum, duodenum, duodenum, duodenum and duodenum. There was no significant difference in the thickness of jejunum and ileum wall between the two groups. There was no significant difference in the CT value of intestinal wall between malignant tumor and adenocarcinoma. The difference of CT value of intestinal wall in venous phase was not statistically significant. The results of group B showed that there was a significant difference between malignant tumor and adenocarcinoma in the long diameter and the residual rate of intestinal cavity. The difference of CT value in arterial phase and venous phase was statistically significant. There was no significant difference in CT value between arterial phase and venous phase. There was no significant difference in CT value in plain scan between all malignant tumors and non-malignant tumors and tumor-like lesions. The difference of the residual rate of tumor length and lumen was statistically significant. The CT value of plain scan, arteriovenous and venous phase was significantly different. After the lymphoma was removed, the tumor diameter, residual rate of intestinal cavity, CT value of plain scan, CT scan were significantly different, and the results showed that the tumor diameter, residual rate of intestinal cavity, CT value of plain scan were significantly higher than that of control group (P < 0.05). There was no significant difference in CT value between arterial phase and venous phase. Conclusion: 1. The CTE image quality of anisodamine is better than that of anisodamine. 2. CTE can fully display the pathological features, according to the length of tumor, the residual rate of intestinal cavity and the CT value of the third stage of the tumor. It can provide basis for diagnosis and differential diagnosis of tumor lesions.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.32;R730.44

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