CT小肠造影对小肠Crohn病的诊断价值  

Diagnostic Value of CT Enteroclysis for Crohn's Disease of the Small Bowel

作　　者：刘炜[1] 秦明伟[1] 潘卫东[1] 林强[1] 陆星华[2] 史济华[2] 王沄[1] 张晓娜[1] 张云庆[1] 赵文敏[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院放射科,100730 [2]中国医学科学院中国协和医科大学北京协和医院消化科

出　　处：《中国消化内镜》2007年第5期42-45,共4页Digestive Disease and Endoscopy

摘　　要：目的研究CT小肠造影对于小肠Crohn病的诊断价值及其限度。方法采用64层螺旋CT,对15例经肠镜、手术和病理诊断的小肠Crohn病患者口服等渗甘露醇后行腹盆CT扫描,包括平扫、动脉期和门脉期扫描,采用多平面重建(Multiplanar Reconstruction,MPR)技术,评价其CT异常征象。结果15例患者小肠充盈评分2.87±0.99(1～4分),CT小肠造影病变表现为肠壁增厚13例(87%),强化增加12例(80%)。发病部位仅累及末段回肠9例(60%),空回肠多个节段受累5例(33%),小肠和结肠同时受累1例。肠管周围蜂窝织炎6例(40%),脓肿和炎性肿块2例,瘘管形成1例。门脉期图像对诊断最有帮助。结论口服等渗甘露醇小肠充盈可满足诊断要求,CT小肠造影可显示Crohn病病变肠壁及其周围并发症,对于指导临床治疗以及评价临床疗效具有重要价值。Objective： To investigate the value and limit of CT e.nteroclysis （CTE） in the diagnosis of small intestinal Crohn＇s disease. Methods：Totally 15 subjects with small intestinal Crohn disease were enrolled, who were diagnosed by endoscopy, surgery anti pathology. Isosmotic mannitol administered perorally, then they received CT scanning including plain scan, the arterial phase scan and the portal venous phase scan. The abnormal CT findings were analyzed. Results： CT enterography performed with isosmotic mannitol administered perorally had a mean luminal distention score of 2.87. Among the 15 cases of CT enterography, there were 13 cases （ 87 %） of mural thickening 12 cases （80%） of increased enhancement of bowel wall 9 cases 60%） of isolated terminal ileal lesion, 5 cases （33%） of skip lesions of the jejunal and ileal loops, 6 cases （40%） of phlegmon, 2 cases of abscesses and inflammatory masses and 1 cases of fistulas. Portal venous phase images were of great value for enabling the detection of Crohn Disease. Conclusion： Noninvasive CT technique with isosmofic mannitol administered perorally achieves adequate luminal distention. CT enterography can demonstrate exactly the diseased bowel wall and extra-intestinal complication of Crohn disease, which is of important value to guide clinic treatment and to assess the effect of treatment.

关 键 词：肠疾病 CROHN病 体层摄影术 

分 类 号：R574.5[医药卫生—消化系统]