Clinical Study Of Spiral Ct Enterography With Isosmotic Mannitol As Oral Contrast In Diagnosis Of Small Intestine Tumors

Objective:To study the clinical application value of spiral CT enterography (SCTE) with orally administered isosmotic mannitol (5.07%) as negative contrast in diagnosis of small intestine tumors.Methods:The study group included 60 patients who were suspected of small disease,10 healthy volunteers and 8 rats from january,2004 to October,2008. The subjects were asked to drink isosmotic mannitol about 1000～1500ml at intervals of 30 minutes before examination, and then 10～20mg of Raceanisodamine hydrochloride was injected intramuscular at 10-15 minutes before examination. Spiral CT scanning in dual-phase was performed at 1.5 hour later.8 rats underwent SCT scan in 10 minutes,20 minutes,30 minutes and 50 minutes after 8ml of 5.07% isosmotic mannitol was inflated into small bowel through a naso-interic tube. Demonstration features of various kinds of small bowel tumors was analyzed by comparing with the results of conventional CT scan in 82 patients, and the diagnostic efficacy of SCTE was evaluated. The sensitivity, specificity, positive predictive value and negative predictive value in conventional CT scan and SCTE were calculated.Results:Only two cases didn't receive satisfactory in filling ileocecal junction, all the other cases in SCTE receiced satisfactory result in filling the duodenum, jejunum, ileum and in demonstrating the bowel tumors. Animal experiments showed that the best filling time of the small intestinal in rats was 50 minutes. The sensitivity, specificity, positive predictive value and negative predictive value in SCTE were 97.22%,95.83%,97.22%,95.83%, which was higher than by conventional CT (76.19%,75%,76.19%,75%). The difference between two modalities in sensitivity and positive predictive value were significant (x2=5.45, x2=5.45, p<0.05)Conclusion:1,Spiral CT enterography with isosmotic mannitol as oral contrast is a simple, rapid, safe, noninvasive, and effective method for evaluating small bowel tumor, it obviously increases the detectability of small intestine tumors.2,Spiral CT enterography with isosmotic mannitol as oral contrast using biphasic enhencing and 3D-imaging reconstruction techniques have an important clinical vale in localize, characterize and staging of interstinal neoplasms.