| Part?Feasibility study of total intestinal CT angiography based on conventional small intestine CTEObjective: To explore the effect of using conventional CT enterography to observe the condition of the colorectal to evaluate its feasibility of one-stop observation of the whole intestine.Methods: 20 healthy volunteers were selected for routine CTE examination,the images were collected and reconstructed.The average thickness and intestinal diameter of the intestinal segments of the whole intestine were measured by reconstructed images by two experienced radiologists.The proportion of the segment in the total length of the intestine group was scored through observing the well-filled intestines.1 point represents a ratio of <30%,2 points represents 30%-50%,3 points represents 50%-80%,and 4 points represents >80%.Then evaluate the feasibility of conventional CTE to examine the whole bowel condition in one stop.Result: The average thickness of the intestinal wall which is well filling was 1.41±0.38 mm,and the difference was not statistically significant(P>0.05).The average diameter of the intestine well filling in the small intestine is more than 2cm,and the one of the intestine well filling in the colon is more than 3cm.The ileum and the entire group of colorectal intestinal dilatation scores were greater than 3.0 points,which meant that the well-filled intestinal segment accounts for 50%-80% of the intestine group.Conclusion: Conventional CTE technology is excellent for observing the intestinal wall of the whole intestine as well as the ileum and colorectal lumen.It can be used for the examination of total intestinal diseases.Part? Comparative study of total intestine CT angiography based on improved bowel preparation and complete bowel preparationObjective: To campare the whole-intestinal CTE examination of patients with simple bowel prepareation method using one-litre polyethylene glycol electrolyte combining with mosapride,which is a selective 5-HT4 receptor agonist,and the full-laxative bowel prepareation method,and to investigate whether the whole-intestinal CTE examination based on the simple bowel prepareation method can improve the patient's tolerance to bowel preparation while ensuring the diagnostic performance.Methods: 60 patients who underwent whole-intestinal CTE examination for obvious gastrointestinal symptoms were selected and divided into 2 groups randomly.The first group of patients(30 patients)were performed complete bowel preparation which is followed the standard of colonoscopy(2 liters of polyethylene glycol electrolyte solution in divided doses),and recorded as FL group;The second group of patients(30 patients)underwent simple bowel preparation(1 liter of polyethylene glycol electrolyte dissolved in combination with the selective 5-HT4 receptor agonist mosapride)and recorded as RL group.The tolerance of the two groups of patients to the intestinal preparation process were recorded.Two groups of patients were examined for whole-intestinal CTE,and two experienced imaging radiologists performed the work of reading and disease detection.The data of endoscopy,surgery and pathology of 60 patients were also collected at the same time.The CTE detection results were compared with clinical data to determine the differences in the diagnostic performance of whole-intestinal CTE based on two bowel preparations for various intestinal diseases.Result: All 60 patients successfully completed the whole-intestinal CTE examination after the bowel preparation and scored the tolerance of the intestinal cleansing process.52 patients were confirmed with positive lesions by clinical informations,and all lesions were confirmed by endoscopic or postoperative pathology.For intestinal non-occupying lesions,24 cases of total intestinal CTE were detected,including 11 cases in the FL group and 13 cases in the RL group.The total sensitivity(SE),specificity(SP),positive predictive value(PPV)and negateve predictive value(NPV)of the whole intestine CTE were 100%,83.3%,80%,and 100%,respectively;FL group was 100%,82.4%,81.3%,and 100%,respectively;RL group was 100 %,84.2%,78.6.3% and 100%,the difference in diagnostic performance between the two groups was not statistically significant(P>0.05).For intestinal space-occupying lesions,24 cases of total intestinal CTE were detected,including 13 cases in the FL group and 11 cases in the RL group.The total sensitivity(SE),specificity(SP),positive predictive value(PPV)and negative predictive value (NPV)of the whole intestine CTE were 41.3%,95.5%,92.8%,and 53.2%,respectively;FL group was 39.4%,94.7%,92.8%,and 47.4%,respectively;RL group was 43.3%,respectively.93.3%,92.8%,and 45.2%,the difference between the diagnostic performance of the two groups was not statistically significant(P>0.05).For lesions with a maximum transverse diameter ? 6 mm,the total SE,SP,PPV and NPV of the whole-intestinal CTE were 12.5%,90%,55.6% and 56.3%,respectively;the FL group was 17.4%,95.8%,80.0% and 54.8%,respectively.The RL group was 5.9%,88.0%,25.0%,and 57.9%,respectively.There was no statistically significant difference in diagnostic performance between the two groups(P>0.05).For lesions with a maximum transverse diameter >6 mm,the total SE,SP,PPV and NPV of the whole-intestinal CTE were 90.5%,91.1%,82.6% and 95.3%,respectively;the FL group was 90.0%,92.0%,81.8% and 95.8%,respectively.The RL group was 90.1%,90.0%,83.3% and 94.7%,respectively.There was no statistically significant difference in diagnostic performance between the two groups(P>0.05).The average score of the intestinal cleansing process of patients in the FL group and the RL group was 2.70 ± 1.37 and 4.33 ± 1.06,respectively,and the difference between the two groups was statistically significant(P < 0.001,t = 5.17).Conclusion: There was no statistically significant difference in the diagnostic performance of whole-intestinal CTE for intestinal non-occupational lesions and space-occupying lesions based on two bowel preparation methods.Patients with simple bowel preparation were more tolerant to the bowel clearing process than which with complete bowel preparation.The differences between the two groups were statistically significant(P < 0.001).At the same time,the method of whole-intestinal CTE examination has a high detection performance for intestinal non-occupation lesions and intestinal space-occupying lesions that are >6 mm,which can provide a powerful help for clinical one-stop observation of whole ntestinal diseases. |
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