MSCT及其后处理技术对克罗恩病的诊断价值  

Diagnostic Value of Multi-slice CT and Post-processing Techniques in Crohn's Disease

作　　者：朱庆强[1] 朱文荣[2] 史玉振[2] 童明敏[1] 林艳飞[2] 王中秋[1] 

机构地区：[1]南京军区南京总医院医学影像科,210002 [2]徐州医学院研究生学院,221000

出　　处：《临床放射学杂志》2011年第8期1146-1149,共4页Journal of Clinical Radiology

摘　　要：目的探讨多层螺旋CT(MSCT)及其后处理技术对克罗恩病(Crohn's disease)的诊断价值及其限度,以提高对该病的诊断水平。资料与方法回顾性分析经病理、肠镜、手术证实的42例克罗恩病患者的MSCT平扫及增强扫描影像资料,在工作站上采用容积再现技术(VRT)、多平面重组(MPR)、最大密度投影(MIP)等技术,分析病变肠管的数量、肠壁厚度和强化、系膜区淋巴结、血管束及并发症等表现。结果 42例中,表现为肠壁增厚(>4mm)36例(85.7%),强化增加(>20～30 HU)33例(78.5%),多节段性病变31例(73.8%),肠腔不规则狭窄34例(80.9%)。系膜区淋巴结肿大(>5 mm)16例(38.1%),系膜区血管束增多、增粗13例(30.9%),肠管周围蜂窝织炎18例(42.8%),腹腔内脓肿10例(23.8%),炎性包块8例(19.1%),不全性肠梗阻14例(33.3%),腹腔积液21例(50%),瘘管形成8例(19.1%),消化道穿孔6例(14.3%)。CT未显示肠壁线形溃疡和"卵石征",对肠瘘的显示率不高。结论 MSCT可明确显示病变肠壁及其周围并发症,对全面评价克罗恩病的范围、并发症及指导临床治疗具有重要作用。Objective To investigate the value and limits of Multi-slice CT（MSCT） and post-processing techniques in the diagnosis of crohn＇s disease.Materials and Methods The MSCT data of 42 patient with Crohn＇s disease were retrospectively analyzed.The multi-planar reformation（MPR）images of abdomen,maximum intensity projection（MIP）and volume rendering（VR）imagings of mesenteric vessels were reconstructed on workstation.The CT features including the number,location of the involved bowel segment,thickness of the bowel wall and enhancement of the bowel wall,lymph node and vascular bundle of the Crohn＇s disease were observed.Results Of all the 42 patients,bowel wall thickening（4 mm）were found in 36（85.7%）,lesions enhancement（20-30 HU）in 33（78.5%）,multiple lesions in 31 cases（73.8%）,bowel segments irregular stenosis in 34（80.9%）,mesentery lymphadenectasis（5 mm）in 16（38.1%）,vascalar bundle thickening in 13（30.9%）,dermatocellulitis in 18（42.8%）,peritoneal abscess in 10（23.8%）,inflammatory masses in 8（19.1%）,incomplete intestinal obstruction in 14（33.3%）,enterobrosis in 6（14.3%）,seroperitoneum in 21（50%）,fistulization in 8（19.1%）.Conclusion The Multi-slice CT（MSCT） and processing techniques are sensitive in the dignosis of Crohn＇s disease,which can help us in evaluating the activity of the disease and guiding the clinical treatment.

关 键 词：克罗恩病体层摄影术 X线计算机图像处理鉴别诊断 

分 类 号：R574[医药卫生—消化系统]