Crohn’s病MRI检查技术和应用价值——15例小肠钡灌对照分析  

MR Imaging Evaluation of the Crohn’s Disease:Comparing with Conventional Enteroclysis

作　　者：许建荣[1] 朱炯[1] 赵锡海[1] 沈谋绩[1] 华佳[1] 钟亮[1] 杨之晖[1] 沈加林[1] 

机构地区：[1]上海第二医科大学附属仁济医院放射科,上海200001

出　　处：《实用放射学杂志》2004年第12期1084-1088,共5页Journal of Practical Radiology

摘　　要：目的　探讨MRI各种序列在分辨Crohn’s病肠道病变、发现并发症以及判断病变活动状态等方面的应用价值。方法　回顾性分析诊断明确的 15例Crohn’s病 ,其中 8例急性发作期 ,7例为静止期。所有病例均完成小肠钡灌肠 (SBE)造影、MRI的SE -T1WI、SE -T2 WI、SPIR -T1WI、SPIR -T2 WI和水成像。结果　Crohn’s病MRI呈现肠壁增厚、形态固定、信号改变、管腔改变、浆膜面毛糙、肠系膜血管毛刷征等征象 ,MRI和SBE显示肠道病变节段的符合率为 90 .8%。MRI各序列就病变肠段的阳性率依次为SE -T2 WI(10 0 % )、SPIR -T2 WI(88.5 % )、水成像 (80 .8% )、SE -T1WI(5 0 .0 % )和SPIR -T1WI(4 8.1% )。病变活动期与静止期的肠壁厚度(t=4.72 9,t0 .0 1( 13 ) =3 .0 12 ,Ρ <0 .0 1)和高信号改变 (χ2 =5 .5 3 ,χ20 .0 5( 1) =3 .84,Ρ <0 .0 5 )均有显著差别。结论　相对SBE而言 ,MRI检查判断Crohn’s病更为全面、安全和简便 。Objective To evaluate the value of MR imaging in estimating the segments of abnormal bowel,discovering the complications, and assessing the activity of Crohn’s disease.Methods All 15 patients with Crohn’s disease ( including 8 cases with active disease and 7 cases with inactive disease) had finished conventional enteroclysis and MR imaging. MR imaging was performed using SE-T 1WI, SE-T 2WI, SPIR-T 1WI, SPIR-T 2WI, and MR enteroclysis.Results The appearances of Crohn’s disease on MRI included wall thickening, morphologic fixation, signal alterations, and so on. 90.8% segment of abnormal bowel detected by MRI correlated well with that by conventional enteroclysis. Using MRI, additional findings outside the bowel could be obtained. The positive rate for revealing abnormal enteric segments were orderly SE-T 2WI(100%), SPIR-T 2WI(88.5%), MR enteroclysis(80.8%), SE-T 1WI(50.0%) and SPIR-T 1WI(48.1%). There were extremely difference between active disease and inactive disease in aspect of thickness (t=4.729,t 0.01(13) =3.012,Ρ<0.01)and high-signal intensity (χ 2=5.53,χ 2 0.05(1) =3.84,Ρ<0.05).Conclusion MRI is more comprehensive, secure and convenient method than conventional enteroclysis to diagnosing Crohn’s disease.

关 键 词：Crohn’s病 小肠 磁共振成像:小肠钡灌肠 

分 类 号：R574[医药卫生—消化系统] R445.2[医药卫生—内科学]