MSCT对结肠Crohn病的诊断价值  

The value of multi-slice CT in the diagnosis of Crohn's disease of colon

作　　者：毛明香[1] 朱希松[1] 

机构地区：[1]衢州市人民医院放射科,浙江324000

出　　处：《放射学实践》2012年第4期436-439,共4页Radiologic Practice

基　　金：衢州市科技局科研基金项目(20101108)

摘　　要：目的:探讨MSCT对结肠Crohn病的诊断价值。方法:回顾性分析经内镜、手术及病理证实的39例结肠Crohn病患者的MSCT影像学表现。结果:39例中多节段病变30例(76.9%),单独大肠受累4例(10.3%)、大肠伴小肠受累35例(89.7%)。大肠病变累及盲肠31例(79.5%)、升结肠26例(66.7%)、横结肠17例(43.6%)、降结肠10例(25.6%)、乙状结肠16例(41.0%)、直肠6例(15.4%)。MSCT征象:肠壁增厚、强化增加、肠壁分层、肠腔狭窄、肠壁脓肿、肠系膜血管增多("梳征")、病变肠管周围纤维脂肪增多、蜂窝织炎、腹腔脓肿和炎性肿块、肛周病变、瘘管/窦道、系膜淋巴结肿等。肠管增厚、肠壁分层、强化增加、肠壁内脓肿、病变肠管周围蜂窝织炎、"梳征"等可提示病变处在活动期。结论:结肠Crohn病易累及盲、升结肠,MSCT表现有一定特征性,MSCT在显示肠壁病变及肠腔外并发症以及判断病变是否在活动期具有优势。Objective：To investigate the value of multi-slice CT（MSCT） in the diagnosis of Crohn′s disease of colon.Methods：The MSCT findings of 39 patients with endoscopy/surgery and pathology proven Crohn′s disease of colon were analyzed retrospectively.Results：Of the 39 patients,there were 30 patients（76.9%） showing multi-segment lesions,4 patients（10.3%） had lesions limited in colon,and 35 patients（89.7%） had simultaneous colon and small intestine involvement.Involvement of cecum was revealed in 31 patients（79.5%）,ascending colon in 26 patients（66.7%）,transverse colon in 17 patients（43.6%）,descending colon in 10 patients（25.6%）,sigmoid colon in 16 patients（41.0%） and rectum in 6 patients（15.4%）.The MSCT findings included bowel wall thickening,mural hyper-enhancement,mural stratification,stenosis of bowel lumen,mural abscess,increase of mesenteric vascularity（comb sign）,peri-intestinal fibrous-adipose proliferation,phlegmon,abscesses or inflammatory masses within abdominal cavity,perianal lesion,fistulas/sinus tracts and mesenteric lymphadenopathy.The CT findings of bowel wall thickening,mural stratification,mural hyper-enhancement,mural abscess,peri-enteric phlegmon,and comb sign were correlated with active inflammation of the disease.Conclusion：Crohn′s disease of colon mainly involve cecum and ascending colon.The MSCT findings of colonic Crohn′s disease are characteristic,which proved to have advantages in depicting mural abnormalities and evaluating extra-luminal complications as well as the activity of the disease.

关 键 词：肠疾病 CROHN病 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]