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目的 对仿真CT肠镜与大肠镜在小儿外科的应用进行比较。方法 对 33例患儿采用日本OlympusPCF2 0大肠镜及美国GE公司Hispead型螺旋CT仿真大肠镜进行检查。大肠镜检查使用Endoview软件记录内镜图像 ,完毕后再进行CT检查 ,使用Insight软件进行CT三维图像重建 ,利用ModifyEndoscopy程序显示肠腔内的形态结构。 结果 本组 33例患儿 ,仿真CT肠镜(CTVE)检出肠重复畸形 2例 ,肠旋转不良 3例 ,结肠冗长症 5例 ,大肠息肉 10例 (漏诊 5例 ) ,溃疡性结肠炎、大肠血管畸形未能检出 ;大肠镜检出肠放置不良 2例 (漏诊 1例 ) ,结肠冗长症 5例 ,大肠息肉15例 ,溃疡性结肠炎 6例 ,大肠血管畸形 2例 ,肠重复畸形未能检出。仿真CT肠镜对诊断肠道畸形具有较高的准确性 ,但对于直径小于 0 .5cm的大肠息肉、肠血管畸形检出率低 ,易漏诊 ;对小儿溃疡性结肠炎的粘膜显示不理想。大肠镜则对于诊断大肠息肉、溃疡性结肠炎、大肠血管畸形有较高的准确性。结论 仿真CT肠镜是诊断肠道畸形的一种有效途径 ,但是对肠道粘膜的病变的显示不理想 ;是大肠镜检的一种重要补充手段
Objective To compare the application of simulated colonoscopy and colonoscopy in pediatric surgery. Methods Totally 33 children were examined by Japan OlympusPCF20 colonoscopy and GE Hispead spiral CT virtual colonoscopy. Colonoscopy using Endoview software to record endoscopic images, after the completion of CT examination, the use of Insight software for CT three-dimensional image reconstruction, the use of ModifyEndoscopy program shows the structure of the intestine. Results In the 33 cases of this group, 2 cases of intestine deformity, 3 cases of intestinal malrotation, 5 cases of colon gracilis, 10 cases of colon polyps (5 cases missed), ulcerative colitis, Colon malformations failed to detect; colonoscopy detected poor placement of bowel in 2 cases (1 missed diagnosis), colon lengthy disease in 5 cases, 15 cases of colorectal polyps, ulcerative colitis in 6 cases, 2 cases of large intestine vascular malformations, intestinal deformity Failed to check out The CT colonoscopy has a high accuracy in the diagnosis of intestinal deformity. However, the detection rate of intestinal vascular malformations is low and easily misdiagnosed for colorectal polyps less than 0.5cm in diameter. The mucosa of ulcerative colitis in children is not ideal. Colonoscopy is the diagnosis of colorectal polyps, ulcerative colitis, large bowel vascular malformations with high accuracy. Conclusion CT colonoscopy is an effective way to diagnose intestinal deformity, but it is not ideal for the display of intestinal mucosal lesions. It is an important supplementary means of colonoscopy