目的 探讨多层CT小肠造影(MSCTE)与单气囊小肠镜(SBE)在小肠梗阻性病变的诊断价值.方法 收集2009年6月-2013年2月临床和/或腹部X线平片疑为小肠梗阻的患者30例.所有患者先行MSCTE检查,根据检查结果选择经口或经肛SBE检查.分析两种检查方法对小肠梗阻性病变的诊断率.结果 ①MSCTE检查诊断小肠梗阻的灵敏度为85.19％,特异度为66.67％,阳性预测值为95.83％,阴性预测值为33.33％.SBE检查分别为81.48％、100％、100％和37.50％.②MSCTE和SBE检出病变一致性为53.33％ (16/30).③根据MSCTE检查结果选择经口或经肛SBE检查,MSCTE检查阳性指导SBE选择进镜方式正确率高于MSCTE检查阴性(95.83％ vs 33.33％,P＜0.05).结论 MSCTE和SBE对小肠梗阻的诊断率相当,二者联合应用可提高对小肠梗阻性病变的诊断率.MSCTE检查结果可以指导SBE选择进镜方式.%Objective To evaluate the diagnostic value of multi-slice CT enterography (MSCTE) before single balloon enteroscopy (SBE) for patients with small bowel obstruction (SBO).Methods 30 patients with MSCTE before SBE for SBO were collected prospectively from Jun.2009 to Feb.2013.The clinical impact of MSCTE on the subsequent SBE examinations and the diagnostic yields of both MSCTE and SBE were evaluated respectively.Results ① In detecting SBO,MSCTE had a sensitivity of 85.19％,a specificity of 66.67％,a positive predictive value of 95.83％,and a negative predictive value of 33.33％.SBE had a sensitivity of 81.48％,a specificity of 100％,a positive predictive value of 100％,and a negative predictive value of 37.5％.② The consistency was 53.33％.③ The choice of initial route of SBE was correct in those with a positive MSCTE vs negative MSCTE (95.83％ vs 33.33 ％,P ＜0.05).Conclusion MSCTE and SBE are nearly equal in their ability to detect SBO.The combined application of two methods can improve the diagnosis rate of SBO.This study suggests MSCTE as a triage tool may identify patients who will benefit from SBE and aid the endoscopist in choosing the most efficient route.
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