256层多排螺旋CT小肠成像对小肠炎症性病变的临床应用研究  

Application of 256 Multi-Detector Computed Tomography Enterography in Small Bowel Inflammatory Diseases

作　　者：解骞[1] 窦娅芳[2] 梁宗辉[3] 朱全东[1] 祝瑞江[1] 

机构地区：[1]复旦大学附属华山医院放射科,上海200040 [2]上海交通大学附属第一人民医院放射科,上海200080 [3]上海市静安区中心医院放射科,上海200040

出　　处：《CT理论与应用研究（中英文）》2013年第2期329-338,共10页Computerized Tomography Theory and Applications

摘　　要：目的:探讨256层多排螺旋CT小肠造影(MDCTE)扫描技术在小肠炎症性病变诊断中的临床应用价值。材料和方法:对118例临床怀疑小肠疾病患者(男53例,女65例,平均年龄48.5岁)行256-MDCTE平扫及增强扫描,通过横断面及多平面重建,观察病变部位、大小、形态、周围情况等与病理结果对照分析。结果:本组118例患者中,小肠炎症性病变25例(男13例,女12例,平均年龄45.5岁),其中Crohn病12例(因克隆恩病肠壁增厚引起不全性小肠梗阻1例),溃疡性结肠炎2例,小肠结核1例,病毒性肠炎1例,小肠黏膜一般炎症7例,另外2例临床无法确诊。MDCTE诊断21例,4例漏诊者均为一般炎症。结论:小肠炎症性病变在MDCTE上具有特征性的表现,MDCTE能全景式、多方位展示小肠肠道、肠系膜和系膜血管,对小肠炎症性疾病的诊断具有重要价值。To discuss the utility of MDCTE for evaluating inflammatory diseases of the small bowel. Materials and methods： At our institution, 118 patients （male 53; female 65; mean age 48.5 years） with symptoms of suspected small bowel diseases underwent 256-MDCTE. Pertinent MDCTE and histopatbology reports were reviewed. The CT appearances characteristic of small-bowel inflammatory bowel disease are described and illustrated in detail, Associated complications and extraenteric manifestations also are described. Results： Of 118 MDCTEs performed, there were 25 cases of small bowel inflammations （male 13; female 12; mean age 45.5 years）. In all 12 cases of Crohn＇s diseases, small bowel involvement was typically transmural, with characteristic skip lesions. CT features of active Crohn＇s disease include mucosal hyper-enhancement, irregular wall thickening, mural stratification with a prominent vasa recta （comb sign）, and mesenteric fat stranding. 2 cases of ulcerative colitis characterized by a continuous pattern of bowel wall involvement, starting from the rectum, without evidence of skip lesions. Ulcerative colitis predominantly involved the large bowel but may extend to the terminal ileum. Extra-intestinal manifestations may occur but were uncommon. Mucosal hyper-enhancement along with circumferential and symmetric bowel wall thickening enhancement of the inner mucosa and outer muscularis pericolonic fat; MDCTE demonstrated findings suggestive was present. There was mural stratification with propria. Mesenteric hyperemia was present in the of intestinal tuberculosis in one patient by depicting ulcero-nodular with strictures, edema and thickening of the ileocecal region, the presence of necrotic mesenteric lymph nodes that were adjacent to a small-bowel thickening. There was 1 case of viral gastroenteritis and 7 cases of generalized small bowel enteritis with non-specific MDCTE features include bowel thickening and submucosal edema appreciable in the entire intestine. Mesenteric vessels were regularly opa

关 键 词：小肠 多层螺旋CT小肠成像 小肠炎症性病变 

分 类 号：R816.5[医药卫生—放射医学]