■虽然小肠出血比较少见,这是一种潜在的致命疾病,它的诊断仍然面临挑战。tech99m标记的红细胞计算机单光子发射计算机断层扫描/计算机断层扫描(99mTc-RBCSPECT/CT)和对比增强的多探测器计算机断层扫描(MDCT)是诊断小肠出血的常用成像方法,但目前还没有研究比较其诊断效能。本研究旨在比较99mTc-RBCSPECT/CT与增强MDCT对小肠出血的诊断价值。
■共有44名患者(30名男性和14名女性,中位年龄64岁)明确诊断为小肠出血和15例非小肠出血患者(男性8例,女性7例,中位年龄66岁)被连续纳入本研究。所有患者于2020年1月至2023年9月在首都医科大学附属北京友谊医院行99mTc-RBCSPECT/CT及增强MDCT检查。明确的诊断是通过手术或结肠镜检查做出的,或者通过病史,患者管理,和临床随访。我们收集了参与者的临床数据。99mTc-RBCSPECT/CT和对比增强MDCT以盲法检查活动性出血和活动性小肠出血位置的准确性。
■在59名患者中,准确性,灵敏度,99mTc-RBCSPECT的特异性为27.3%,93.3%,92.3%;99mTc-RBCSPECT/CT为76.3%,40.5%,和93.3%;而对于对比增强MDCT,它们是45.8%,27.3%,100%,分别。99mTc-RBCSPECT/CT对空肠和回肠出血的诊断准确率高,100%和86.4%,分别。同时,99mTc-RBCSPECT/CT在诊断更多小肠出血原因方面具有较高的准确性。在59名患者中,99mTc-RBCSPECT/CT联合对比增强MDCT可准确诊断小肠出血,并在50例患者中提供精确定位,导致准确性,灵敏度,特异性为84.7%,79.5%,和100.0%,分别。
■99mTc-RBCSPECT/CT对小肠出血具有较高的诊断价值,优于99mTc-RBCSPECT和对比增强MDCT。99mTc-RBCSPECT/CT联合增强MDCT可进一步提高诊断准确率,能准确指导小肠出血的诊断和治疗。
UNASSIGNED: Although small bowel bleeding is relatively rare, it is a potentially fatal disease, and its diagnosis still faces challenges. Technetium 99m-labeled red blood cell computed single photon emission computed tomography/computed tomography (99mTc-RBC SPECT/CT) and contrast-enhanced multidetector computed tomography (MDCT) are common imaging methods for diagnosing small bowel bleeding, but there have been no studies comparing their diagnostic efficacy for this purpose. This study aims to compare the diagnostic value of 99mTc-RBC SPECT/CT and contrast-enhanced MDCT for small bowel bleeding.
UNASSIGNED: A total of 44 patients (30 males and 14 females, median age of 64 years) definitively diagnosed with small bowel bleeding and 15 non-small bowel bleeding patients (8 males and 7 females, median age of 66 years) were consecutively included in this study. All patients underwent 99mTc-RBC SPECT/CT and contrast-enhanced MDCT examinations at Beijing Friendship Hospital of Capital Medical University between January 2020 to September 2023. The definitive diagnosis had been made through surgery or colonoscopy, or through patient history, patient management, and clinical follow-up. We collected clinical data of the participants. 99mTc-RBC SPECT/CT and contrast-enhanced MDCT were reviewed in a blinded fashion for accuracy of detection of active bleeding as well as the active small bowel bleeding location.
UNASSIGNED: Among the 59 patients, the accuracy, sensitivity, and specificity of 99mTc-RBC SPECT were 27.3%, 93.3%, and 92.3%; for 99mTc-RBC SPECT/CT they were 76.3%, 40.5%, and 93.3%; whereas for contrast-enhanced MDCT they were 45.8%, 27.3%, and 100%, respectively. The diagnostic accuracy of 99mTc-RBC SPECT/CT for jejunal and ileal bleeding was high, at 100% and 86.4%, respectively. Meanwhile, 99mTc-RBC SPECT/CT had a higher accuracy in diagnosing more causes of small bowel bleeding. In 59 patients, the combination of 99mTc-RBC SPECT/CT and contrast-enhanced MDCT accurately diagnosed small bowel bleeding and provided precise localization in 50 patients, resulting in the accuracy, sensitivity, and specificity of 84.7%, 79.5%, and 100.0%, respectively.
UNASSIGNED: 99mTc-RBC SPECT/CT has high diagnostic value in diagnosing small bowel bleeding and is superior to 99mTc-RBC SPECT and contrast-enhanced MDCT. The combination of 99mTc-RBC SPECT/CT and contrast-enhanced MDCT can further improve the diagnostic accuracy of diagnosis, and can accurately guide the diagnosis and treatment of small bowel bleeding.