双源CT诊断非金属可疑食管异物的队列研究

Cohort study of diagnosis for suspicious nonmetal foreign body in esophagus by dual source

摘要:

目的通过分析双源CT诊断非金属食管异物的敏感性和特异性，评价双源CT对非金属可疑食管异物的诊断意义。方法应用前瞻性队列研究，选取2015年1月1日～2016年12月31日符合纳入标准的患者153例双源CT和正侧位平片对照。结果93例双源CT阳性示食管异物，其中57例平片阳性；内镜检查证实并取出92例，内镜检查阴性1例。本组病例中双源CT敏感性100%（92/92），特异性98.4%（60/61），阴性预测值100%（60/60）。结论双源CT检查非金属食管异物敏感性、特异性、阴性预测值高，能明确异物类型及异物位置。双源CT可作为非金属食管异物的常规检查，及时诊断，避免不必要的食管内镜检查。

Abstract:

ObjectiveTo investigate the diagnostic value of dual source computed tomography (DSCT) for suspicious nonmetal foreign body in the esophagus.MethodsA prospective study was performed on 153 patients with a history of suspicious nonmetal foreign body impaction by comparing their DSCT and anteroposterior and lateral position Xray films.ResultsOf all the 153 patients, DSCT showed foreign body in 93 cases with positive plain film results in 57. Endoscopic confirmation and removal of esophageal foreign body was achieved in 92 of the 93 patients, and one patient got negative endoscopic examination result. For the diagnosis of esophageal nonmetal foreign body, the sensitivity of DSCT was 100%(92/92) and the specificity was 98.4%(60/61) with a negative predictive value of 100%(60/60).ConclusionWith high sensitivity, specificity and negative predictive value, DSCT can be applied to identify the type and location of esophageal nonmetal foreign body. Therefore, DSCT should be considered as the firstchoice diagnostic technique for esophageal nonmetal foreign body for expedited diagnosis and avoidance of unnecessary esophagoscopic examination.