多排螺旋CT三维肠道成像在克罗恩病诊断中的影像价值  

Value of Multi-slice Helical Intestinal CT in Diagnosis of Crohn’s Disease

作　　者：宋涛[1] 生晶[1] 刘敬禹[1] 黄俊[2] 陆建平[1] 

机构地区：[1]第二军医大学长海医院放射科 [2]三亚市解放军第425医院放射科

出　　处：《中国医学计算机成像杂志》2013年第3期235-237,共3页Chinese Computed Medical Imaging

基　　金：上海市科委2008年国际科技合作基金项目批准号:08210707600~~

摘　　要：目的:回顾性分析肠管炎性增厚征、肠周间隙模糊征及病灶多节段征在诊断克罗恩病中的应用价值。方法:应用Siemens Somatom 64层螺旋CT对29例经肠镜及病理诊断为克罗恩病的患者行肠道CT成像,并三维重建获取多平面重建MPR图、结肠aysum图及腹盆腔动脉VR图。结合原始薄层横断面等图像进行分析,并与肠镜及病理对照。结果:29例肠镜诊断为克罗恩病的患者中:肠道病变部位管壁明显强化并持续强化者为27例,敏感度为93.10%;肠周脂肪间隙模糊者为20例,敏感度为68.97%;25例患者病灶呈多节段性,敏感度为86.21%。肠壁炎性增厚与肠周脂肪间隙模糊共同诊断克罗恩病为20例,敏感性为68.97%,兼具肠壁炎性增厚与病灶多节段性分布的患者为24例,敏感性为82.76%,肠周脂肪间隙模糊与病灶多节段性分布都具有的患者为18例,敏感性为62.07%,三因素共同诊断克罗恩病的敏感性为62.07%。结论:肠管炎性增厚征、肠周间隙模糊征及病灶多节段征在诊断克罗恩病中均具有提示作用,其中肠管炎性增厚征、病灶多节段征价值较高。Purpose： To determine the value of CT features of mural thickening, fuzziness of peri- intestinal space, segmental lesions in diagnosing Crohn＇ s disease （CD）. Methods： Twenty-nine patients with known Crohn＇ s disease were retrospectively evaluated. All patients underwent multi-slice helical CT （Siemens Somatom Sensation Cardiac 64） to gain multiple planar reformation （MPR） images, aysum map of colon, volume rendering （VR） images of celiac and pelvic artery. The CT results were compared with endoscopy and pathological diagnosis. Results： The sensitivity of features of mural thickening, fuzziness of peri-intestinal space, segmental lesions in diagnosing Crohn＇ s disease were 93.10% （27/29）, 68.97% （20/29） and 82.76% （24/29）. The sensitivity of features of mural thickening and fuzziness of peri-intestinal space were 68.97% （20/29）. The sensitivity of features of mural thickening, segmental lesions were 82.76%（24/29）. The sensitivity of features of fuzziness of peri-intestinal space, segmental lesions were 62.07%（18/29）. The sensitivity of combined features of these 3 signs was 62.07%（18/29）. Conclusion： CT features of mural thickening, fuzziness of peri-intestinal space, and segmental lesions may suggest diagnosis of CD. Features of mural thickening and segmental lesions have higher diagnostic value.

关 键 词：克罗恩病 小肠 体层摄影术 X线计算机 

分 类 号：R574[医药卫生—消化系统]