Application Value Of Peroral Mannitol Salt Water Multislice Spiral CT Enterography Of Small Bowl

Objective:60 patients who were suspected of having small-bowel dieases underment MSCT enterography with peroral mannitol salt water for estimating small-bowel distention and investigating the diagnostic value of small-bowel diseases.Methods:60 patients who were suspected of various kinds of small intestine diseases were examined.All patients were assigned to drink a total of 1500-2000 ml mannitol salt water (2.5%mannitol+0.7%NaCl) for 3-4 times in 45-60 minutes,each time 500ml per 15-20 minutes. CT scanning was performed,when 20mg of Raceanisodamine hydrochloride was injected intramuscularly 10 minutes later.The filling degree of small intestine was classified as satisfactery,better and no satesfactery. It was classified as dense-type,uniformity-type and divergence type accord to the length and superposition of small intestine.The maximum outer diameter of duodenum,jejunum,and ileum were measured respectively in different segments accord to non small-bowl obstruction and small-bowl obstruction.The diagnostic value of MSCTE in small bowl diseases was judged by ultimum clinical diagnosis accord to the results of surgery or enteroscope and biopsy-pathology, sensitivity,specificity,accuracy,positive predictive value and negative predictive value was calculated,regularity of result of MSCTE and ultimum clinical diagnosis was reviewed (expressed by kappa value)Results 55 patients were administered 1500-2000ml mannitol salt water,5 patients were only administered 500ml,the slightly hypsi mannitol salt water was acceptable by patients,except 2 patients have diarrhea.The filling degree of intestine was classified as satisfactory 45 cases,better 10 cases and no satisfactory 5 cases. The maximum outer diameters of small bowel of non-obstruction group in different segments is duodenum 2.32±0.32cm,jejunum 2.57±0.39cm,and ileum 2.17±0.22cm, the maximum outer diameters of the other group in different segments is duodenum 2.22±0.25cm,jejunum 4.14±0.97cm,and ileum4.36±1.16cm. The length and superposition of small intestine was classified as dense-type 7 cases,uniformity-type 27 cases and straggling-type 26 cases. Lumen,bowl wall,mesentery vasculacture,lymph nodes and extraluminal organs changes of many kinds of small intestine diseases were displayed clearly,there were included Crohn's diseaes 4 cases, tuberculosis 3 cases, small intestine tumor 30 cases,other small intestine disease 11 cases,colon carcinoma 8 cases, normal 4 cases. Sensitivity, specificity, accuracy, positive predictive value,and negative predictive value of detection of MSCTE in smalll bowl disease each is 97.9%,91.7%,96.7%,97.9%,91.7%,regularity of result of MSCTE and ultimum clinical diagnosis was best strongest,kappa=0.896.Conclusion:Peroral mannitol salt water MSCTE of small bowl for distending the small bowel is a simple and reliable method for evaluating all aspects of small bowel diseases,MSCTE also is a good methd of discrimination of small bowel and abdominal cavity diease at the same time.