CT小肠造影在克罗恩病诊断中的应用  

Application of CT enteroclysis in Crohn′s Disease

作　　者：陈冰心[1] 朱兰香[1] 陈卫昌[1] 

机构地区：[1]苏州大学附属第一医院消化病科,江苏省215006

出　　处：《江苏医药》2013年第17期2034-2036,共3页Jiangsu Medical Journal

摘　　要：目的探讨CT小肠造影(CTE)在克罗恩病(CD)诊断中的应用价值。方法回顾性分析30例确诊CD的临床资料,取胃肠道无明显病变者25例作为对照。分析CD患者病灶部位、肠壁厚度、强化、肠外表现和并发症等特点,探讨以上CTE表现与ESR和疾病活动度的关系。结果CD病变回肠25例(83.3%),最常见的CTE改变为肠壁增厚和强化28例(93.3%);其次为肠壁分层27例(90.0%)。CTE可清晰显示CD的肠周改变,如木梳征、肠系膜脂肪密度增高、淋巴结肿大、腹腔脓肿和瘘管等。CTE对CD的诊断符合率为80.0%。ESR与瘘管或脓肿等并发症有关(r=0.402,P<0.01)。疾病活动度与肠壁强化(r=0.526,P<0.01)、瘘管或脓肿(r=0.545,P<0.01)高度相关,与肠壁分层模式也有关(r=0.363,P<0.05)。结论 CTE可清晰显示CD的肠壁病变及并发症,有助于临床诊断、判断疾病活动度和指导合理治疗。Objective To evaluate the role of CT enteroclysis（CTE） in the diagnosis of Crohn＇ s disease（CD）. Methods Data of 30 patients with CD were retrospectively analyzed, which were compared with those of 25 cases without gastrointestinal diseases. CT images of CD were analyzed, which included the position of every focus thickness of intestinal wall, types of intestinal wall thickening, stenosis of enteric cavity, CT attenuations of intestinal wall, complications and CD-adjacent organs. Results Ileum was most frequently involved in CD（83.30//00）. Small bowel wall thickening and mural enhancement were the most cormnon signs of CD. CTE showed highly clear images of small bowel wall, thickening and stenosis of enteric cavity, and complications such as mesenteric edema, mesenteric thickening, mesenteric lymph nodes hyperplasia, phlegmon, peritoneal abscess, sinus and fistula. Compared to the colonoscopy findings, the coincidence rate o{ CTE in the diagnosis of CD was 80.0%. ESR was closely correlated with sinus and fistula（r：0. 402, P〈0. 01）. The activity of CD was closely correlated with mural enhancement （r=0. 526, P〈0.01）, sinus and fistula（r=0. 545, P〈0. 01）. Conclusion CTE can clearly show the abnormalities of small bowel wall and complications of CD, which is helpful in the diagnosis and evaluation of the activity and complications of CD.

关 键 词：CT小肠造影 克罗恩病 

分 类 号：R445[医药卫生—影像医学与核医学]