多层螺旋CT成像技术在克罗恩病诊断中的应用价值  

The value of multi-slice spiral CT imaging technique in the diagnosis of intestinal Crohn's disease

作　　者：沈宣文[1] 陈浩[1] 马建明[1] 郑志勇[1] 庄启湘[1] 庞智[2] 尹少朋[2] 

机构地区：[1]苏州市立医院北区影像科,215008 [2]苏州市立医院北区消化科,215008

出　　处：《中华消化病与影像杂志（电子版）》2013年第1期20-22,共3页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的探讨多层螺旋CT(MSCT)成像技术在克罗恩病(CD)诊断中的应用价值。方法选择2010年7月至2012年4月苏州市立医院经临床、内镜、病理学等方法证实并均有MSCT平扫和增强扫描检查完整资料的CD患者72例。所有病例均行肠道清洁,并在检查前口服足量等渗2.5%甘露醇水溶液,充分扩张肠腔后,作MSCT平扫和增强扫描,分别获得平扫与增强的轴位图像,经计算机处理后进行多平面重建并观察。结果 72例CD患者中空肠与回肠同时受累10例,回肠与结肠同时受累15例,病变累及回盲瓣26例。病变肠段236处,呈多节段跳跃式分布;所有病变部位均见肠壁增厚,其中肠壁分层环壁增厚53处,偏侧(系膜侧)性增厚82处,多节段混合性增厚101处;肠腔狭窄与肠壁增厚相伴存在;黏膜异常强化225处,强化程度视病变活动性而异;肠系膜血管增粗增多101处,肠系膜淋巴结增大增多91处;并发不全梗阻4例,脓肿形成2例。结论 MSCT以口服等渗2.5%甘露醇水溶液充盈肠腔并作增强扫描结合多平面重建技术,对CD的定位、病变活动性的判断、并发症的显示均有较高诊断价值。Objective To investigate the value of multi-slice spiral CT （MSCT） imaging technique in the diagnosis of intestinal Crohn＇s disease （CD）. Methods MSCT plain scan and enhanced scan data of 72 patients with pathologically confirmed CD in Suzhou Municipal Hospital North from July 2010 to April 2012 were retrospectively analysed. All cases did bowel cleaning and orally taken sufficient quantities of isotonic 2.5% mannitol solution in order to expand enterocoel fully before undergoing MSCT examination.Axial images of scan and enhancement and three-dimensional reconstruction images were acquired and observed. Results The lesions located at jejunum and rileum in 10 patients, ileum and colon in 15 patients, jileocecal valve in 26 patients ; 236 lesions were observed and distributed discontinuously. All lesions showed bowel wall thickening, mural stratification and circular thickening in 53 lesions, unilateral thickening in 82 lesions, multiple segmental mixed thickening in 101 lesions; luminal narrowing coexisted with bowel wall thickening; mucosa abnormal enhancement in mucosa in 225 lesions, and the degree of enhancement depended on disease activity; thickening and increasing of mesenteric vessel in 101 lesions, hickening and increasing of mesenteric lymph node in 91 lesions; 4 cases with incomplete obstruction and 2 cases with abscess formation. Conclusion MSCT combined with enhanced scan and reconstruction technique has high diagnostic value in lesion localization, judgement of activity degree and showing cmplications.

关 键 词：体层摄影术 螺旋计算机 克罗恩病 诊断 

分 类 号：R574[医药卫生—消化系统]