克罗恩病合并肛瘘的MSCT表现  

MSCT findings of Crohn's disease complicated with anal fistula

作　　者：庄启湘[1] 沈宣文[1] 陈浩[1] 郑志勇[1] 胡春洪[2] 

机构地区：[1]江苏省苏州市立医院北区放射科,江苏苏州215008 [2]苏州大学附属第一医院影像中心,江苏苏州215008

出　　处：《中国中西医结合影像学杂志》2014年第2期127-129,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨MSCT对克罗恩病(Crohn’s disease,CD)合并肛瘘以及CD活动期的诊断价值。方法:回顾性分析22例CD合并肛瘘患者的临床及影像资料,患者均行全腹部MSCT,结合MSCT重建图像,分析病变肠壁的厚度、黏膜强化程度、肠系膜血管改变、肠系膜淋巴结、肠腔狭窄及肛瘘情况。结果:22例CD患者中15例经外科手术治疗肛瘘,其中复发7例,CT图像均表现为肠壁明显增厚、明显强化、肠系膜血管增多、肠系膜淋巴结增多、肠腔明显狭窄;未复发8例,CT表现为肠壁增厚8例、肠壁明显强化1例、肠系膜血管增多3例、肠系膜淋巴结增多3例、肠腔狭窄4例。22例CD患者,CT表现为肠壁增厚21例(95.5%),肠壁强化22例(100%),肠系膜血管增多17例(77.3%),肠系膜淋巴结增多17例(77.3%),肠腔狭窄16例(72.7%)。结论:肛瘘是否术后复发与肠道病变的MSCT表现有关。Objective：To discuss the diagnostic value of Crohn＆#39;s disease （CD） with anal fistula and the value of diagnosing the activity period of CD by multi-slice spiral computed tomography （MSCT ） .Methods ：Retrospective analysis was made on the clinical and imaging data of 22 patients with CD complicated anal fistula ,all cases underwent total abdominal MSCT examina-tion ,combined with MSCT image reconstruction ,analysis of intestinal wall lesions ,enhancement of intestinal wall thickness , mesenteric vascular changes ,mesenteric lymph nodes ,lumen stenosis and fistula .Result：Among the 22 CD patients ,15 cases were by surgical operation treatment of anal fistula ,including 7 cases of recurrence ,CT images showed intestinal wall thicken-ing ,obvious enhancement ,mesenteric vessels increased ,mesenteric lymph nodes increased ,enteric stenosis .No recurrence in 8 cases ,CT images showed thickened bowel wall in 8 cases （100% ） ,bowel wall enhancement in 1 cases （12 .5% ） ,mesenteric vas-cular increased in 3 cases （37 .5% ） ,mesenteric lymph nodes increased in 3 cases （37 .5% ） ,lumen stenosis in 4 cases （50% ） .22 cases of CD patients ,CT showed the intestinal wall thickening in 21 cases （95 .5% ） ,bowel wall enhancement in 22 cases （100% ） ,mesenteric vascular increased in 17 cases （77 .3% ） ,mesenteric lymph nodes increased in 17 cases （77 .3% ） ,lumen stenosis in 16 cases （72 .7% ） .Conclusion：Recurrence of anal fistula of CD is relative with the intestinal performances of CD on MSCT .

关 键 词：CROHN病 直肠瘘 体层摄影术  X线计算机 

分 类 号：R574[医药卫生—消化系统] R657.16[医药卫生—内科学] R816.5[医药卫生—临床医学]