本文選題：CT小腸造影　切入點(diǎn)：小腸腫瘤　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:1.探討山莨菪堿對(duì)CT小腸造影檢查的影響。2.探討CT小腸造影在小腸腫瘤性病變?cè)\斷中的應(yīng)用價(jià)值。材料與方法:A組:選擇患者40人,分成實(shí)驗(yàn)組與對(duì)照組,各20人,實(shí)驗(yàn)組肌注山莨菪堿低張腸道,對(duì)照組不應(yīng)用山莨菪堿,為空白對(duì)照;對(duì)十二指腸、空腸及回腸的腸腔寬度、腸壁厚度及雙期增強(qiáng)腸壁CT值進(jìn)行測(cè)量,應(yīng)用兩獨(dú)立樣本W(wǎng)ilcoxon秩和檢驗(yàn);對(duì)腸腔充盈程度進(jìn)行評(píng)分,采用兩獨(dú)立樣本U檢驗(yàn);均以P0.05為差異有統(tǒng)計(jì)學(xué)意義。B組:回顧性分析2015年01月至2017年01月在我院進(jìn)行CTE檢查并經(jīng)手術(shù)病理證實(shí)為小腸腫瘤性病變的患者,共32例,其中包括惡性腫瘤19例(淋巴瘤10例、腺癌9例),非惡性腫瘤及腫瘤樣病變13例(間質(zhì)瘤9例、血管瘤1例、異位胰腺2例及炎性假瘤1例)。分別測(cè)量惡性腫瘤、非惡性腫瘤及腫瘤樣病變的腫瘤長(zhǎng)徑、腸腔殘留率及三期CT值,對(duì)惡性腫瘤與非惡性腫瘤及腫瘤樣病變進(jìn)行比較。惡性腫瘤與非惡性腫瘤及腫瘤樣病變的比較包括兩部分,一部分為全部惡性腫瘤與非惡性腫瘤及腫瘤樣病變的比較,另一部分為剔除淋巴瘤后的惡性腫瘤與非惡性腫瘤及腫瘤樣病變的比較。均應(yīng)用兩獨(dú)立樣本W(wǎng)ilcoxon秩和檢驗(yàn),以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:A組結(jié)果顯示,十二指腸實(shí)驗(yàn)組與對(duì)照組腸腔寬度、腸腔充盈度評(píng)分及增強(qiáng)動(dòng)脈期腸壁CT值差異均有統(tǒng)計(jì)學(xué)意義(P=0.000,P=0.017,P=0.015;P0.05);空腸實(shí)驗(yàn)組與對(duì)照組腸腔充盈度評(píng)分及增強(qiáng)動(dòng)脈期腸壁CT值差異均有統(tǒng)計(jì)學(xué)意義(P=0.01,P=0.001;P0.05);回腸實(shí)驗(yàn)組與對(duì)照組腸腔充盈度評(píng)分及增強(qiáng)動(dòng)脈期腸壁CT值差異均有統(tǒng)計(jì)學(xué)意義(P=0.005,P=0.003;P0.05)。十二指腸、空腸及回腸腸壁厚度差異均無統(tǒng)計(jì)學(xué)意義(P=0.079,P=0.116,P=0.818;P0.05);靜脈期腸壁CT值差異均無統(tǒng)計(jì)學(xué)意義(P=0.685,P=0.358,P=0.13;P0.05)。B組結(jié)果顯示惡性腫瘤中淋巴瘤與腺癌腫瘤長(zhǎng)徑及腸腔殘留率差異有統(tǒng)計(jì)學(xué)意義(P=0.001,P=0.001;P0.05);動(dòng)脈期CT值及靜脈期CT值差異有統(tǒng)計(jì)學(xué)意義(P=0.007,P=0.014;P0.05);平掃CT值差異無統(tǒng)計(jì)學(xué)意義(P=0.109,P0.05)。在全部惡性腫瘤與非惡性腫瘤及腫瘤樣病變的比較中,腫瘤長(zhǎng)徑、腸腔殘留率差異有統(tǒng)計(jì)學(xué)意義(P=0.004,P=0.009;P0.05);平掃及動(dòng)、靜脈期CT值差異有統(tǒng)計(jì)學(xué)意義(P=0.012,P=0.010,P=0.016;P0.05)。剔除淋巴瘤后結(jié)果顯示腫瘤長(zhǎng)徑、腸腔殘留率、平掃CT值、動(dòng)脈期及靜脈期CT值差異均無統(tǒng)計(jì)學(xué)意義(P=0.295,P=0.642,P=0.218,P=0.0.79,P=0.235;P0.05)。結(jié)論:1.應(yīng)用山莨菪堿的CTE圖像質(zhì)量?jī)?yōu)于不應(yīng)用山莨菪堿。2.CTE能充分顯示病變特征,依據(jù)腫瘤長(zhǎng)徑、腸腔殘留率及腫瘤三期CT值的差異,可以為腫瘤性病變的診斷與鑒別診斷提供依據(jù)。
[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.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R735.32;R730.44

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